Provider Demographics
NPI:1205425196
Name:TALTON, DAWN STACY (RPH)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:STACY
Last Name:TALTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 GREENWAY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4975
Mailing Address - Country:US
Mailing Address - Phone:828-355-3350
Mailing Address - Fax:
Practice Address - Street 1:579 GREENWAY RD STE 100
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4975
Practice Address - Country:US
Practice Address - Phone:828-355-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist