Individual provider · Type 1 NPI

Tabitha Waller, FNP

Family Nurse Practitioner · Roseburg, OR

NPI number 1619410982 Active

Practice location

1813 W Harvard Ave, Suite 241
Roseburg, OR 97471-2752

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X20160204NP-PP (OR)

Family Nurse Practitioner: Definition to come...

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About NPI 1619410982

Tabitha Waller, FNP's National Provider Identifier is 1619410982, issued on Nov 18, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Roseburg, OR. The record was last updated on Nov 18, 2016.