Provider Demographics
NPI:1164606281
Name:DALTON, TOMARRA M (CRNP)
Entity Type:Individual
Prefix:
First Name:TOMARRA
Middle Name:M
Last Name:DALTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TOMARRA
Other - Middle Name:M
Other - Last Name:WHITTINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-3165
Mailing Address - Fax:717-334-3140
Practice Address - Street 1:423 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2526
Practice Address - Country:US
Practice Address - Phone:717-339-3165
Practice Address - Fax:717-334-3140
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009672363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2013604OtherHIGHMARK BS FREEDOM BLUE
PA210533OtherJOHNS HOPKINS
MD918403OtherCAREFIRST MD BCBS
PA50074901OtherCAPITAL BLUE CROSS-WMG
PA1569554OtherGATEWAY-WMG
PA210533OtherJOHNS HOPKINS