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NPI Code Detail

MEDICARE: LOUISA CHARLENE TALI

MEDICARE: LOUISA CHARLENE TALI
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
1363L00000XNurse Practitioner9839575-4405UT

General Provider Information

NPI Number : 1295476125
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUISA CHARLENE TALI
Provider Business Mailing Address
First Line : 1250 E 3900 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-1348
Country : US
Telephone Number : 801-265-2000
Fax Number : 801-265-2008
Provider Business Practice Location Address
First Line : 1250 E 3900 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-1348
Country : US
Telephone Number : 801-265-2000
Fax Number : 801-265-2008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2022
Last Update Date : 01/07/2026

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Directions to “ LOUISA CHARLENE TALI ” Practice Location

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