Provider Demographics
NPI:1508204157
Name:TALLARICO, JENNIFER YARBOROUGH (RN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:YARBOROUGH
Last Name:TALLARICO
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:3183 ASHLEY RIVER RD
Mailing Address - Street 2:DRAYTON HALL ELEMENTARY SCHOOL
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7101
Mailing Address - Country:US
Mailing Address - Phone:843-852-2045
Mailing Address - Fax:843-852-2069
Practice Address - Street 1:3183 ASHLEY RIVER RD
Practice Address - Street 2:DRAYTON HALL ELEMENTARY SCHOOL
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-7101
Practice Address - Country:US
Practice Address - Phone:843-852-2045
Practice Address - Fax:843-852-2069
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC60168163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool