Provider Demographics
NPI:1861572984
Name:CRABTREE-VOLLRATH, TARA (APRN, NP)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:CRABTREE-VOLLRATH
Suffix:
Gender:F
Credentials:APRN, NP
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:CRABTREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, NP
Mailing Address - Street 1:2060 READING RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1454
Mailing Address - Country:US
Mailing Address - Phone:513-721-3200
Mailing Address - Fax:513-639-3186
Practice Address - Street 1:7459 STATE RD
Practice Address - Street 2:SUITE 325
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2154
Practice Address - Country:US
Practice Address - Phone:513-233-2000
Practice Address - Fax:513-624-2684
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.09119-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner