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

Tara Mallory

Individual provider Licensed Practical Nurse · NPI 1982563433

Tara Mallory is a Licensed Practical Nurse in Roscommon, Michigan. Licensed in Michigan. Registered with an NPI since 2026.

Licensed in
MI
In the registry since
2026

Practice location Address checks out

5705 September Ln
Roscommon, MI 48653-8756
Phone: (989) 325-0576
Show map & directions

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

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 4703083153 (MI)

Record details

NPI number1982563433
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedJanuary 20, 2026
Last updated in NPPESJanuary 20, 2026
Certification dateJanuary 20, 2026
Mailing address5705 September Ln, Roscommon, MI 48653-8756

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