Provider Demographics
NPI:1073128195
Name:TALLE, MARIE SCHMEHL
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:SCHMEHL
Last Name:TALLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5404 TALLADEGA DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-7857
Mailing Address - Country:US
Mailing Address - Phone:614-284-2556
Mailing Address - Fax:
Practice Address - Street 1:5404 TALLADEGA DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-7857
Practice Address - Country:US
Practice Address - Phone:614-284-2556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2533164376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker