Healthcare Provider Details

I. General information

NPI: 1003325150
Provider Name (Legal Business Name): TAMARA RENA POSTLETHWAIT FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2017
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WAYNE ST STE 100
MARIETTA OH
45750-3309
US

IV. Provider business mailing address

1903 ANN ST
PARKERSBURG WV
26101-2504
US

V. Phone/Fax

Practice location:
  • Phone: 740-568-2214
  • Fax: 740-568-2099
Mailing address:
  • Phone: 304-424-4249
  • Fax: 304-420-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022114
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-64878FNP-BC
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: