Provider Demographics
NPI:1437332293
Name:FLOWERS, TALMAH
Entity Type:Individual
Prefix:MS
First Name:TALMAH
Middle Name:
Last Name:FLOWERS
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 1:2979 N PALMER ST
Mailing Address - Street 2:A
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2428
Mailing Address - Country:US
Mailing Address - Phone:414-587-7012
Mailing Address - Fax:414-535-1196
Practice Address - Street 1:2979 N PALMER ST
Practice Address - Street 2:A
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-2428
Practice Address - Country:US
Practice Address - Phone:414-587-7012
Practice Address - Fax:414-535-1196
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WINA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44019500Medicaid