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General NPI Number Information
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NPI Number | 1194188516
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Entity Type | Individual
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Provider Name | JODI TALLMAN NP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2016
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 6758 HIGHWAY 362 W STE A
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City | WILLIAMSON
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State | GA
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Zip | 30292-3397
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Country | US
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Telephone | 470-980-7520
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Fax | 866-596-4671
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Provider Business Mailing Address
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Address Line | 6758 HIGHWAY 362 W STE A
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City | WILLIAMSON
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State | GA
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Zip | 30292-3397
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Country | US
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Telephone | 470-980-7520
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Fax | 866-596-4671
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN170855
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN170855
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License Number State | GA
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