Provider Demographics
NPI:1538638861
Name:TALBOT, LEKELSI DANSIE (BSN)
Entity Type:Individual
Prefix:MRS
First Name:LEKELSI
Middle Name:DANSIE
Last Name:TALBOT
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-1507
Mailing Address - Country:US
Mailing Address - Phone:801-399-7263
Mailing Address - Fax:801-399-7256
Practice Address - Street 1:477 23RD ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-1507
Practice Address - Country:US
Practice Address - Phone:801-399-7263
Practice Address - Fax:801-399-7256
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8326007-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse