Individual provider · Type 1 NPI

Jennifer Tallis, PA-C

Medical Physician Assistant · Newark, DE

NPI number 1356626865 Active

Practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-0001

Call (302) 733-1000 Map

Mailing address

1834 Lovering Ave, Apt 2
Wilmington, DE 19806-2122

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XC5-0000790 (DE)

Medical Physician Assistant: Definition to come...

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About NPI 1356626865

Jennifer Tallis, PA-C's National Provider Identifier is 1356626865, issued on Oct 15, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Newark, DE. The record was last updated on Oct 15, 2011.