IndividualActive
Jennifer Tallis, PA-C
NPI 1356626865 · Medical Physician Assistant · Newark, DE
Provider details
- NPI number
- 1356626865
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- C5-0000790 (DE)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4755 Ogletown Stanton Rd
Newark, DE 19718-0001
Phone: (302) 733-1000
Approximate (ZIP-level) locationGet directions
Mailing address
1834 Lovering Ave
Wilmington, DE 19806-2122
Registry dates
- Enumerated
- 2011-10-15
- Last updated
- 2011-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.