Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704131665 | MI |
N | 363LN0000X | Nurse Practitioner - Neonatal | 4704131665 | MI |
NPI | 1205900594 |
---|---|
Provider Name | Ms. Deborah Marie Talbot |
First Address | Shelby Township, MI 48316-5336 |
Second Address | Detroit, MI 48236-2148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 17/06/2015 |