Wallace, Tamara Jane

Wallace, Tamara Jane is an individual health care provider with primary practice located at 700 Childrens Dr , Columbus OH 43205-2664. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Wallace, Tamara Jane can be contacted via phone (614) 361-8430.

Contact Information

Primary practice address
700 Childrens Dr Columbus OH 43205-2664
Phone: (614) 361-8430
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X APN0000015454 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 01255 Ohio

Profile Details

NPI number 1073780045
LBN Legal business name Wallace, Tamara Jane
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2008
Last updated Mar 28th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073780045 NPPES
Ohio MEDICAID 0201101
Ohio Other 606646
Ohio Other 4299578
Ohio MEDICAID 129252
Ohio MEDICAID 003109104C
Ohio Other 003109104C

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