Provider Demographics
NPI:1861491573
Name:STRASSELL, TAMARA A (CNP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:A
Last Name:STRASSELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MACK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5335
Mailing Address - Country:US
Mailing Address - Phone:513-751-4222
Mailing Address - Fax:513-751-4353
Practice Address - Street 1:3000 MACK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5335
Practice Address - Country:US
Practice Address - Phone:513-751-4222
Practice Address - Fax:513-751-4353
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN182453363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2412580Medicaid
OHP00892985OtherMEDICARE RAILROAD
IN200442180Medicaid
KY78010527Medicaid
OH2412580Medicaid
OHNP12214Medicare PIN