Provider Demographics
NPI:1770387391
Name:HALSELL, TAMERA NICOLE
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:NICOLE
Last Name:HALSELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5846 ABBEY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1597
Mailing Address - Country:US
Mailing Address - Phone:330-777-9334
Mailing Address - Fax:
Practice Address - Street 1:5846 ABBEY CHURCH RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1597
Practice Address - Country:US
Practice Address - Phone:330-777-9334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRV7833953747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant