Provider Demographics
NPI:1144101817
Name:TARKENTON, MAKAYLA FAITH
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:FAITH
Last Name:TARKENTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2184
Mailing Address - Country:US
Mailing Address - Phone:717-208-0131
Mailing Address - Fax:
Practice Address - Street 1:814 EDGEHILL AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4120
Practice Address - Country:US
Practice Address - Phone:717-208-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant