MEDICARE: MS. JOANNE MARIE TALAREK RN, MSN, C-ANP

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	363LA2200X	Adult Health Nurse Practitioner	4704104615	MI

General Provider Information

NPI Number	:	1730250135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNE MARIE TALAREK RN, MSN, C-ANP

Provider Business Mailing Address
First Line	:	39595 W 10 MILE RD
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48375-2948
Country	:	US
Telephone Number	:	248-476-6980
Fax Number	:	248-476-7462

Provider Business Practice Location Address
First Line	:	164 MCLEAN
Second Line	:
City	:	BRUCE TWP
State	:	MI
Zip	:	48065-4919
Country	:	US
Telephone Number	:	586-336-3467
Fax Number	:	586-336-3574

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

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	02/03/2016

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