Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tara Hannah Shouldis

Individual provider Pediatric Registered Nurse · NPI 1386435139

Tara Hannah Shouldis is a Nurse Practitioner in Providence, Rhode Island. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in Rhode Island.

Years since qualifying
1
Licensed in
RI
In the registry since
2025
Specialties on file
2

Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-4000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence APRN04746 (RI)
Pediatric Registered Nurse Taxonomy 163WP0200X · Licence 80652 (RI)

Record details

NPI number1386435139
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 13, 2025
Last updated in NPPESAugust 12, 2025
Certification dateJuly 16, 2025
Mailing address110 Elm St, Providence, RI 02903-4626

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Providence