Individual
ELISA ANN TALBOT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
W12345 HWY 16-60, COLUMBUS, WI 53925-8901
(920) 623-4938
Mailing address
W12345 HWY 16-60, COLUMBUS, WI 53925-8901
(920) 623-4938
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26133-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39946800
—
WI
Enumeration date
11/21/2005
Last updated
07/09/2007
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