Doctor Name: | MICHELLE TALBERT |
NPI Number: | 1225477540 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 24170909 |
Business Practice Address: | 8988 Fern Park Dr Burke, VA - 220151635 |
Business Phone Number: | 7039786061 |
Business Fax Number: | |
Mailing Address: | 8988 Fern Park Dr, BURKE |
State: | VA |
Postal Code: | 220151635 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/19/2013 |
NPI Last Update Date: | 06/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 24170909 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |