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Individual
ROBERTA LOUISE TAILLON
Active
Individual
ROBERTA LOUISE TAILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP128664
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3532608-01
WELLMED MEDICAID
TX
01
—
434419YLPS
WELLMED MEDICARE
TX
Enumeration date
07/30/2015
Last updated
10/18/2016
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