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General NPI Number Information
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NPI Number | 1588029029
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Entity Type | Individual
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Provider Name | PAULA KAYE TALLEY AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 1101 E. MARSHALL ST. DEPT. OF DIABETES & ENDOCRINOLOGY
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City | RICHMOND
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State | VA
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Zip | 23298-5051
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Country | US
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Telephone | 804-827-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 E MARSHALL ST RM 7-013
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City | RICHMOND
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State | VA
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Zip | 23298-5008
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Country | US
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Telephone | 804-827-2119
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024172855
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License Number State | VA
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