| Doctor Name: | TAMMI TALLARICO |
| NPI Number: | 1750758645 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, CNP |
| License Number: | CNP 4057 |
| Business Practice Address: | 203 United Way Frederic, WI - 548378938 |
| Business Phone Number: | 7153274402 |
| Business Fax Number: | |
| Mailing Address: | 4437 399th St, NORTH BRANCH |
| State: | MN |
| Postal Code: | 550567072 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/26/2015 |
| NPI Last Update Date: | 08/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | CNP 4057 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |