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General NPI Number Information
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NPI Number | 1215967443
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Entity Type | Individual
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Provider Name | JENNIFER ANN TALKINGTON CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 11/10/2017
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Provider Practice Location Address
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Address Line | 1255 PINEVIEW DR
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City | MORGANTOWN
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State | WV
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Zip | 26505-2738
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Country | US
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Telephone | 304-598-3301
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Fax | 304-225-0927
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Provider Business Mailing Address
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Address Line | 571 PHEASANT RIDGE RD
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City | BRIDGEPORT
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State | WV
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Zip | 26330-7984
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Country | US
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Telephone | 304-709-3506
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Fax | 304-225-0927
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 46020
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License Number State | WV
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