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

Tara Wulff Bolka, FNP-C

Individual provider Family Nurse Practitioner · NPI 1558894329

Tara Wulff Bolka, FNP-C is a Nurse Practitioner in LA Grande, Oregon. Qualified in 2017, 9 years ago. Practices with Independence Emergency Group LLC, a 20-clinician group and accepts Medicare assignment. Licensed in Alabama, Louisiana and Oregon.

Years since qualifying
9
Licensed in
AL, LA, OR
In the registry since
2017
Specialties on file
3
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

506 4th St
LA Grande, OR 97850-1906
Phone: (541) 663-3138
Fax: (541) 975-5120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 201910351NP-PP (OR)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 1-089967 (AL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 203981 (LA)

Record details

NPI number1558894329
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedApril 7, 2017
Last updated in NPPESMarch 6, 2024
Certification dateMarch 6, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Independence Emergency Group Llc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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