# TAMMY S WALBERT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1710986187
- **Gender:** F
- **Credential:** FNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | LG-0000356 | DE | — |
| 363L00000X | Nurse Practitioner | R110410 | MD | Yes |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 08/27/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1000036982 | — | DE |
| 01 | — | 1184832040 | GROUP NPI | MD |
| 01 | — | 409710600 | MEDICAID MARYLAND | MD |