| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MICHELLE DENISE GRIMSLEY TALLMAN | 1023755782 | 2022-05-15 |
Michelle Denise Grimsley Tallman is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1023755782. Registration indicates Michelle Denise Grimsley Tallman is a provider of access to pediatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Pediatrics, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Pediatrics, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Ms. Michelle Denise Grimsley Tallman NP |
| Practice Office Address | 7015 SAINT IVES BLVD HUDSON, OH US |
| Practice Office Telephone | 3309981706 |
| Mailing Address | 7015 SAINT IVES BLVD HUDSON, OH 442363285 US |
| Business Telephone | 3309981706 |
| Code | Practice | License No State |
|---|---|---|
| 363LP0200X PRIMARY | Access to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Pediatrics All Other Specialties & Provider Types Nurse Practitioner Pediatrics Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | APRNCNP0030092
OH |