Provider Demographics
NPI:1780297739
Name:TALLENT, ASHLEY (APRN, FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TALLENT
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1060
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-1060
Mailing Address - Country:US
Mailing Address - Phone:870-448-5733
Mailing Address - Fax:
Practice Address - Street 1:1094 CATHOLIC POINT RD
Practice Address - Street 2:
Practice Address - City:CENTER RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72027-8403
Practice Address - Country:US
Practice Address - Phone:501-893-6197
Practice Address - Fax:501-893-6199
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR125976363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care