Provider Demographics
NPI:1215117742
Name:TALBERT, STEPHANIE AYANNA-LYNNE
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:AYANNA-LYNNE
Last Name:TALBERT
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 1:1211 DUNBAR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-6625
Mailing Address - Country:US
Mailing Address - Phone:301-773-7467
Mailing Address - Fax:301-773-1610
Practice Address - Street 1:1211 DUNBAR OAKS DR
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-6625
Practice Address - Country:US
Practice Address - Phone:301-773-7467
Practice Address - Fax:301-773-1610
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography