Individual
TAMARA ANN MCNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
420 W 4TH ST, MISHAWAKA, IN 46544-1948
(574) 252-0304
Mailing address
PO BOX 6489, SOUTH BEND, IN 46660-6489
(574) 472-6700
(574) 472-6746
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
72000001A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000578093
BLUE CROSS
IN
05
—
100466420
—
IN
01
—
11479732
CAQH
—
Enumeration date
06/01/2006
Last updated
06/11/2009
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