Provider Demographics
NPI:1104343243
Name:TALLMAN, AISLING MARGARET (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AISLING
Middle Name:MARGARET
Last Name:TALLMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 UNIVERSITY ROW APT 124
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-1446
Mailing Address - Country:US
Mailing Address - Phone:1413-265-3418
Mailing Address - Fax:
Practice Address - Street 1:725 UNIVERSITY ROW
Practice Address - Street 2:APT 124
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705
Practice Address - Country:US
Practice Address - Phone:413-265-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4175-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant