Provider Demographics
NPI:1538109079
Name:TALLEY, MICHELE L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:L
Last Name:TALLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 MONTCLAIR RD
Mailing Address - Street 2:SUITE 955
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1923
Mailing Address - Country:US
Mailing Address - Phone:205-599-3700
Mailing Address - Fax:205-599-3744
Practice Address - Street 1:860 MONTCLAIR RD
Practice Address - Street 2:SUITE 955
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1923
Practice Address - Country:US
Practice Address - Phone:205-599-3700
Practice Address - Fax:205-599-3744
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-080168363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q55175Medicare UPIN