MEDICARE: YOLANDA TALAMANTES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184073298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA TALAMANTES

Provider Business Mailing Address
First Line	:	4130 TELLBROOK CT
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011
Country	:	US
Telephone Number	:	575-805-5236
Fax Number	:

Provider Business Practice Location Address
First Line	:	4130 TELLBROOK RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-7526
Country	:	US
Telephone Number	:	575-805-5236
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2016
Last Update Date	:	06/09/2016

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Directions to “ YOLANDA TALAMANTES ” Practice Location

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