Provider Demographics
NPI:1023252707
Name:WALLEN, TRAM T (DNP, APRN, C-NP)
Entity type:Individual
Prefix:
First Name:TRAM
Middle Name:T
Last Name:WALLEN
Suffix:
Gender:F
Credentials:DNP, APRN, C-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 N PIMA RD.
Mailing Address - Street 2:STE. 210
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:480-425-8700
Mailing Address - Fax:
Practice Address - Street 1:1 PARKVIEW PL # 6800-P
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1038
Practice Address - Country:US
Practice Address - Phone:314-362-1388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ258169363L00000X
MO2004020175363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health