MEDICARE: HOLLY L TALKINGTON CRNA

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	367500000X	Certified Registered Nurse Anesthetist	NE100782	NE

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457328122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY L TALKINGTON CRNA

Provider Business Mailing Address
First Line	:	6465 NORTHERN HILLS DR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68152-1041
Country	:	US
Telephone Number	:	402-572-6500
Fax Number	:	402-572-6501

Provider Business Practice Location Address
First Line	:	16901 LAKESIDE HILLS CT
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2318
Country	:	US
Telephone Number	:	402-572-6500
Fax Number	:	402-572-6501

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	09/01/2009

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Directions to “ HOLLY L TALKINGTON CRNA” Practice Location

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