Individual provider · Type 1 NPI

Jill D. Tallman, PA-C

Medical Physician Assistant · Grand Rapids, MI

NPI number 1689835720 Active

Practice location

4069 Lake Dr SE, Suite 315
Grand Rapids, MI 49546-8816

Call (616) 284-8950 Map

Fax (616) 284-8951

Mailing address

100 Michigan St NE, Mc 845
Grand Rapids, MI 49503-2560

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X5601005232 (MI)

Medical Physician Assistant: Definition to come...

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About NPI 1689835720

Jill D. Tallman, PA-C's National Provider Identifier is 1689835720, issued on Jun 20, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Grand Rapids, MI. The record was last updated on Mar 3, 2021.