Provider Demographics
NPI:1861272601
Name:VANDERWERF-MEYERINK, TARA (DCN, CNS, FDNP)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:VANDERWERF-MEYERINK
Suffix:
Gender:F
Credentials:DCN, CNS, FDNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 WHITE RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8997
Mailing Address - Country:US
Mailing Address - Phone:614-570-9288
Mailing Address - Fax:
Practice Address - Street 1:1488 WHITE RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8997
Practice Address - Country:US
Practice Address - Phone:614-570-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9552133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist