Individual
JEANIENE ANNE TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3860 W ANN RD, N LAS VEGAS, NV 89031-4409
(702) 474-4110
Mailing address
PO BOX 92001, LAS VEGAS, NV 89193-2001
(702) 474-4110
(702) 240-8790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10389
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018827
—
NV
05
—
3102827
—
NV
Enumeration date
02/07/2006
Last updated
08/02/2021
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