| Provider / Organization | NPI | Date Certified |
|---|---|---|
| STEPHANIE ROSEMAN TULLAR | 1962100669 | 2023-08-12 |
Stephanie Roseman Tullar is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1962100669. Registration indicates Stephanie Roseman Tullar is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, ) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Mrs. Stephanie Roseman Tullar FNP-BC |
| Practice Office Address | 3161 E PALMER WASILLA HWY STE 1C WASILLA, AK US |
| Practice Office Telephone | 9073571818 |
| Mailing Address | 4900 E PALMER WASILLA HWY STE 106 WASILLA, AK 996547752 US |
| Business Telephone | 9072066860 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 460 N Dawson Cir | Palmer, AK 996457727 | 7165480633 |
| 3161 E Palmer Wasilla Hwy Ste 1C | Wasilla, AK 996547271 | 9073571818 |
| 3505 E Meridian Park Loop Ste 100 | Wasilla, AK 996547242 | 9078640022 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | F350501-01
NY |
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 203286
AK |
| 193400000X SING | Group Code |