Stephanie Roseman Tullar, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10009557 Issued in OR

Practice address

195 N Main St
Mount Angel, OR 97362-6900

Phone

(503) 662-9339

NPI assigned

Feb 21, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Altair Integrative Wellness

  • Sports Physician Chiropractor
  • Wasilla, AK
  • NPI 1932744836

  Single Specialty

  NPD
• Altair Chiropractic, LLC

  • Chiropractor
  • Wasilla, AK
  • NPI 1225272594

  Single Specialty

  NPD (past)
• Dopanine LLC

  • Registered Dietitian
  • Eagle River, AK
  • NPI 1740846807
  NPD (past)
• Integrated Wellness & Center for Birth, LLC

  • Multi-Specialty Clinic/Center
  • Wasilla, AK
  • NPI 1184806176

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1962100669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 N MAIN ST",
            "city": "MOUNT ANGEL",
            "state": "OR",
            "postal_code": "973626900",
            "telephone_number": "503-662-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 N MAIN ST",
            "city": "MOUNT ANGEL",
            "state": "OR",
            "postal_code": "973626900",
            "telephone_number": "503-662-9339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3161 E Palmer Wasilla Hwy Ste 1C",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996547271",
            "country_code": "US",
            "telephone_number": "907-357-1818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3505 E Meridian Park Loop Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996547242",
            "country_code": "US",
            "telephone_number": "907-864-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLAR",
        "first_name": "STEPHANIE",
        "middle_name": "ROSEMAN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F350501-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "203286",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10009557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Silverton Health
• Dollie Marie Smith, OTR/L
• Katherine Allyn Sprauer
• Staci Carrol Sprauer, LMT
• Brittany Nicole Thiemens, DPT
• Amy Uselman, DPT
• Amy Van Goey
• Analisa Vanoostrum, DPT
• Kasey Danielle Werner, OTD, OTR/L
• Corey W Whirledge

• Family Nurse Practitioner in Mount Angel, OR
• Providers in Mount Angel, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.