Provider Demographics
NPI:1407455470
Name:TALLMAN, EMILY KATE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KATE
Last Name:TALLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 E MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2864
Mailing Address - Country:US
Mailing Address - Phone:304-472-4227
Mailing Address - Fax:
Practice Address - Street 1:86 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2864
Practice Address - Country:US
Practice Address - Phone:304-472-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator