Provider Demographics
NPI:1255806469
Name:BOBBITT, TALINA MICHELLE
Entity type:Individual
Prefix:
First Name:TALINA
Middle Name:MICHELLE
Last Name:BOBBITT
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 1:6489 STATE HIGHWAY 184
Mailing Address - Street 2:
Mailing Address - City:HEMPHILL
Mailing Address - State:TX
Mailing Address - Zip Code:75948-4317
Mailing Address - Country:US
Mailing Address - Phone:936-201-5343
Mailing Address - Fax:
Practice Address - Street 1:6489 STATE HIGHWAY 184
Practice Address - Street 2:
Practice Address - City:HEMPHILL
Practice Address - State:TX
Practice Address - Zip Code:75948-4317
Practice Address - Country:US
Practice Address - Phone:936-201-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX335656164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse