TARA NICOLE KIDD NPI 1285341826

NPI Information

  • NPI: 1285341826
  • Provider Name: TARA NICOLE KIDD
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 907 MAR WALT DR STE 2013
    FORT WALTON BEACH, FL
    ZIP 32547
  • Phone: (817) 354-5200

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NPI Details

Tara Nicole Kidd is a psychiatric/mental health nurse practitioner in Fort Walton Beach, FL with 4 years of experience. Tara Nicole Kidd NPI is 1285341826. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

907 MAR WALT DR STE 2013
FORT WALTON BEACH, FL
ZIP 32547-756
Phone: (817) 354-5200
Fax: (773) 492-8765

The NPI 1285341826 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/2/2022 and was last updated on 2/22/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health1098257TEXASNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11027520FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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