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General NPI Number Information
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NPI Number | 1588429336
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Entity Type | Individual
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Provider Name | CONNIE S TALBOTT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 150 W CHURCH ST APT 4
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City | WINTERSVILLE
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State | OH
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Zip | 43953-9229
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Country | US
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Telephone | 740-275-6097
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Fax |
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Provider Business Mailing Address
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Address Line | 150 W CHURCH ST APT 4
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City | WINTERSVILLE
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State | OH
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Zip | 43953-9229
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Country | US
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Telephone | 740-275-6097
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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 | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | NULL
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