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NPI Code Detail

MEDICARE: MARTHA TALLEY RN

MEDICARE: MARTHA TALLEY RN
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
1163W00000XRegistered NurseRN0000155193TN

General Provider Information

NPI Number : 1821128638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA TALLEY RN
Provider Business Mailing Address
First Line : 216 ZIFFELL DR
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-6148
Country : US
Telephone Number : 615-893-6837
Fax Number :
Provider Business Practice Location Address
First Line : 140 DOVER ST
Second Line :
City : SHELBYVILLE
State : TN
Zip : 37160-2776
Country : US
Telephone Number : 931-684-3426
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 07/08/2007

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