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General NPI Number Information
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NPI Number | 1447049168
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Entity Type | Individual
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Provider Name | LINDA TALLEDO RNC-IBCLC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 2100 CENTRAL AVE STE D1
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City | AUGUSTA
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State | GA
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Zip | 30904-6709
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Country | US
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Telephone | 706-843-6241
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Fax | 706-843-6242
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Provider Business Mailing Address
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Address Line | PO BOX 7660
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City | NORTH AUGUSTA
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State | SC
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Zip | 29861-7660
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Country | US
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Telephone | 706-843-6241
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Fax | 706-843-6242
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | RN095775
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | RN095775
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN095775
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN095775
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN095775
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License Number State | GA
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