Provider Demographics
NPI:1184956062
Name:TALBOTT, HILLARY LYNN (AP, DOM)
Entity type:Individual
Prefix:MS
First Name:HILLARY
Middle Name:LYNN
Last Name:TALBOTT
Suffix:
Gender:F
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 5TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6703
Mailing Address - Country:US
Mailing Address - Phone:727-321-6969
Mailing Address - Fax:727-321-6903
Practice Address - Street 1:2941 5TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6703
Practice Address - Country:US
Practice Address - Phone:727-321-6969
Practice Address - Fax:727-321-6903
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2785171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC00CLOtherBCBS OF FL PROVIDER #