| Doctor Name: | MRS. TARRA J WALTMIRE |
| NPI Number: | 1407108764 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 310088 |
| Business Practice Address: | 933 Mckinley St Van Wert, OH - 458911044 |
| Business Phone Number: | 4192039939 |
| Business Fax Number: | |
| Mailing Address: | 933 Mckinley St, VAN WERT |
| State: | OH |
| Postal Code: | 458911044 |
| Phone Number: | 4192039939 |
| Fax Number: | |
| NPI Enumeration Date: | 10/11/2012 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC3500X |
| License Number: | 310088 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Cardiac Rehabilitation |
| Taxonomy Definition: | |