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General NPI Number Information
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NPI Number | 1942330014
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Entity Type | Individual
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Provider Name | JASON MATTHEW TALLMAN RN, APN-BC
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 2017 JEFFERSON ST SW
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City | ROANOKE
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State | VA
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Zip | 24014-2419
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Country | US
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Telephone | 540-981-8025
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone |
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Fax |
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 873397-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN0000135328
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APN14483
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0100144-C-NP
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024186428
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F404803-01
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License Number State | NY
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