SearchMichiganLicensed Practical Nurse

Tara Mallory

NPI 1982563433 · on the registry since 2026

Practice

Address
5705 September Ln
Roscommon, MI 48653
Phone
(989) 325-0576

Registry record

Primary taxonomy
Licensed Practical Nurse
164W00000X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-01-20

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan