Healthcare Provider Details

I. General information

NPI: 1427266469
Provider Name (Legal Business Name): TAMI A DALENBERG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 ROSS RD
BELLVILLE OH
44813-9043
US

IV. Provider business mailing address

5860 CLEVER RD
BELLVILLE OH
44813-9394
US

V. Phone/Fax

Practice location:
  • Phone: 419-886-3524
  • Fax:
Mailing address:
  • Phone: 419-631-3464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN274282
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: