MEDICARE: MS. KIMBERLY L TALBOT ARNP

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
1	364SA2200X	Adult Health Clinical Nurse Specialist	74374	KS

General Provider Information

NPI Number	:	1437151727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY L TALBOT ARNP

Provider Business Mailing Address
First Line	:	2260 N RIDGE RD STE 240
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-1138
Country	:	US
Telephone Number	:	316-838-7700
Fax Number	:	316-838-8770

Provider Business Practice Location Address
First Line	:	2260 N RIDGE RD STE 240
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-1138
Country	:	US
Telephone Number	:	316-838-7700
Fax Number	:	316-838-8770

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	11/08/2019

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