Healthcare Provider Details

I. General information

NPI: 1710986187
Provider Name (Legal Business Name): TAMMY S WALBERT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY S CAHALL FNP-BC

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E CARROLL ST
SALISBURY MD
21801
US

IV. Provider business mailing address

100 E CARROLL ST ATTN: PRMG
SALISBURY MD
21801-5422
US

V. Phone/Fax

Practice location:
  • Phone: 302-539-1026
  • Fax:
Mailing address:
  • Phone: 410-543-7531
  • Fax: 410-912-6386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG-0000356
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR110410
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: