Provider Demographics
NPI:1427208545
Name:KROLOW, TAMERA ARLEE (RN, PA-C)
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:ARLEE
Last Name:KROLOW
Suffix:
Gender:F
Credentials:RN, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2364A BLIZZARD LN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:45710-9287
Mailing Address - Country:US
Mailing Address - Phone:740-566-4720
Mailing Address - Fax:740-566-4721
Practice Address - Street 1:2364A BLIZZARD LN
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OH
Practice Address - Zip Code:45710-9287
Practice Address - Country:US
Practice Address - Phone:740-566-4720
Practice Address - Fax:740-566-4721
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH50001803363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHQ26640Medicare UPIN
OHPA23681Medicare PIN