Healthcare Provider Details

I. General information

NPI: 1609138585
Provider Name (Legal Business Name): KARLIN HASKINS TALERICO CRNA, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 12/07/2024
Certification Date: 12/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12335 WAKE UNION CHURCH RD STE 203
WAKE FOREST NC
27587-4527
US

IV. Provider business mailing address

7420 RIDGE FALLS LN
WAKE FOREST NC
27587-8015
US

V. Phone/Fax

Practice location:
  • Phone: 919-720-0467
  • Fax:
Mailing address:
  • Phone: 919-720-0467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number224009
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number91106
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019607
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: