MEDICARE: MARIAN S TALMON FNP

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	207Q00000X	Family Medicine Physician	RN079039	AZ

General Provider Information

NPI Number	:	1831193523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAN S TALMON FNP

Provider Business Mailing Address
First Line	:	4559 W BUTLER DR
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-5202
Country	:	US
Telephone Number	:	623-847-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	8811 N 51ST AVE
Second Line	:	SUITE 107
City	:	GLENDALE
State	:	AZ
Zip	:	85302-4949
Country	:	US
Telephone Number	:	623-931-5001
Fax Number	:	623-931-5120

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/09/2007

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