Provider Demographics
NPI:1144956426
Name:TOOTLE, TARYN NOELLE (PA-C)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:NOELLE
Last Name:TOOTLE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:960 TALBOTT LN APT 1417
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-2034
Mailing Address - Country:US
Mailing Address - Phone:770-714-3230
Mailing Address - Fax:
Practice Address - Street 1:4351 BOOTH CALLOWAY RD STE 101
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7319
Practice Address - Country:US
Practice Address - Phone:817-284-1165
Practice Address - Fax:817-590-9721
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant