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NPI Code Detail

MEDICARE: TERESA TALBOT NP

MEDICARE: TERESA TALBOT NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerAP5422AZ
2363LA2100XAcute Care Nurse PractitionerAP5422AZ

General Provider Information

NPI Number : 1205252103
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA TALBOT NP
Provider Business Mailing Address
First Line : PO BOX 33269
Second Line :
City : PHOENIX
State : AZ
Zip : 85067-3269
Country : US
Telephone Number : 602-406-4786
Fax Number : 916-636-4358
Provider Business Practice Location Address
First Line : 500 W THOMAS RD STE 600
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4221
Country : US
Telephone Number : 602-406-1140
Fax Number : 602-406-1149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2014
Last Update Date : 11/07/2024

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