Provider Demographics
NPI:1831752591
Name:HESS, TAMARA JO (FNP-C)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:JO
Last Name:HESS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68501 BANNOCK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9736
Mailing Address - Country:US
Mailing Address - Phone:740-695-1202
Mailing Address - Fax:740-695-8890
Practice Address - Street 1:68501 BANNOCK RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9736
Practice Address - Country:US
Practice Address - Phone:740-695-1202
Practice Address - Fax:740-695-8890
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH024458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0419337Medicaid