Dr. Tamara Jane Wallace
Nurse Practitioner - Neonatal
700 Childrens Dr
Columbus
, Ohio 43205-2664
Dr. Tamara Jane Wallace
Nurse Practitioner - Neonatal
700 Childrens Dr
Columbus
, Ohio 43205-2664
(614) 361-8430
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About
Features
Specialties
- Nurse Practitioner - Neonatal
Languages spoken
- English
Location
First Address
- Dr. Tamara Jane Wallace
- 6283 Enclave Blvd
- Westerville, OH
- Zip : 43082-7576
- Phone : (614) 361-8430
Second Address
- Dr. Tamara Jane Wallace
- 700 Childrens Dr
- Columbus, OH
- Zip : 43205-2664
- Phone : (614) 361-8430
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Is Dr. Tamara Jane Wallace a sole practitioner?
Is Dr. Tamara Jane Wallace accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0000X | Nurse Practitioner - Neonatal | 01255 | OH |
| N | 363LN0000X | Nurse Practitioner - Neonatal | APN0000015454 | TN |
National Provider Identifier
| NPI | 1073780045 |
|---|---|
| Provider Name | Dr. Tamara Jane Wallace |
| First Address | Westerville, OH 43082-7576 |
| Second Address | Columbus, OH 43205-2664 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/05/2008 |
| Last Update Date | 04/01/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 003109104C | (05) | GA |
| 003109104C | AMERIGROUP GA (01) | GA |
| 129252 | (05) | AL |
| 4299578 | TNCARE BLCARE (01) | TN |
| 606646 | WELL CARE (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.