Provider Demographics
NPI:1790484756
Name:KEHLENBECK, TALEE
Entity Type:Individual
Prefix:
First Name:TALEE
Middle Name:
Last Name:KEHLENBECK
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 1:5077 CLINTON STREET RD APT 6
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1170
Mailing Address - Country:US
Mailing Address - Phone:585-356-0337
Mailing Address - Fax:
Practice Address - Street 1:5077 CLINTON STREET RD APT 6
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1170
Practice Address - Country:US
Practice Address - Phone:585-356-0337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY516170163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse