| Doctor Name: | MRS. TARA A ABERNATHY |
| NPI Number: | 1194066712 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 17376 |
| Business Practice Address: | 1164 W Poplar Ave Collierville, TN - 380173196 |
| Business Phone Number: | 9012466955 |
| Business Fax Number: | 9018537303 |
| Mailing Address: | 1164 W Poplar Ave, COLLIERVILLE |
| State: | TN |
| Postal Code: | 380173196 |
| Phone Number: | 9012466955 |
| Fax Number: | 9018537303 |
| NPI Enumeration Date: | 03/06/2013 |
| NPI Last Update Date: | 03/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 17376 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |