Provider Demographics
NPI:1912223967
Name:TALTON, JUDY CZIOTKA (MSN/ARNP)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:CZIOTKA
Last Name:TALTON
Suffix:
Gender:F
Credentials:MSN/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 SW 91ST DR STE A
Mailing Address - Street 2:4809 SW 91ST TERRACE
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8140
Mailing Address - Country:US
Mailing Address - Phone:352-367-9602
Mailing Address - Fax:
Practice Address - Street 1:4750 SW 91ST DR STE A
Practice Address - Street 2:4809 SW 91ST TERRACE
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-8140
Practice Address - Country:US
Practice Address - Phone:352-367-9602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9203768363LA2100X
FLARNP9203768363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDD778ZMedicare PIN