TARA NICOLE GRESHAM HS/SF-IDC NPI 1679601413

NPI Information

NPI: 1679601413
Provider Name: TARA NICOLE GRESHAM, HS/SF-IDC
Classification: Military Health Care Provider - 171000000X
Entity Type: Individual
Address:
2000 BAINBRIDGE AVE
U.S. COAST GUARD MLEA MEDICAL
NORTH CHARLESTON, SC
ZIP 29405
Phone: (843) 740-3147
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Tara Nicole Gresham, HS/SF-IDC is a military health care provider in North Charleston, SC. The provider is active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. Tara Nicole Gresham, HS/SF-IDC NPI is 1679601413. 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:

2000 BAINBRIDGE AVE
U.S. COAST GUARD MLEA MEDICAL
NORTH CHARLESTON, SC
ZIP 29405-607
Phone: (843) 740-3147

The enumeration date for this NPI number is 3/2/2007 and was last updated on 12/1/2014.

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	Primary
1	146N00000X	Emergency Medical Technician, Basic	No
2	171000000X	Military Health Care Provider	Yes
3	247200000X	Technician, Other	No

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: 11/14/2023

NPI Synchronization or Removal

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