Provider Demographics
NPI:1457148538
Name:TALLENT, TERESA E (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:E
Last Name:TALLENT
Suffix:
Gender:
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:EDEN
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:8349 PENDRAGON CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-2412
Mailing Address - Country:US
Mailing Address - Phone:808-681-9024
Mailing Address - Fax:
Practice Address - Street 1:3161 E WARM SPRINGS RD STE 400
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3144
Practice Address - Country:US
Practice Address - Phone:702-463-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV833127163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse