Individual ProviderTara ThiryNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10601 S Western Ave Ste 120, Oklahoma City, OK 73170-6215(405) 615-3570PECOS EnrollmentBased on the most recent information from CMS, provider Tara Thiry does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 7:33 AM.Profile DetailsProvider ID1619380995Provider TypeIndividualFull NameThiry, TaraTitleMs.CredentialNP-CGenderFemaleSole ProprietorNoEnumeration Date6/4/2014Last Updated10/16/2023Contact InformationPractice LocationPractice Address10601 S Western Ave Ste 120, Oklahoma City, OK 73170-6215Phone(405) 615-3570FaxUnlisted FaxMailing LocationMailing Address8237 SW 109th Ter, Oklahoma City, OK 73173-7350Phone(405) 615-3570FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense80150Oklahoma