Individual
MR. KENDARIUS S TALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
221 W COLORADO BLVD STE 525, DALLAS, TX 75208-2312
(214) 960-5681
(214) 960-5681
Mailing address
107 LINDA DR, MONROE, LA 71203-6709
(318) 547-3510
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1049487
TX
363LA2100X
Acute Care Nurse Practitioner
1049487
TX
363LA2100X
Acute Care Nurse Practitioner
13684
WI
363LA2100X
Acute Care Nurse Practitioner
Primary
RN1042832
DC
363LG0600X
Gerontology Nurse Practitioner
1049487
TX
363LG0600X
Gerontology Nurse Practitioner
13684
WI
Other
Enumeration date
10/08/2018
Last updated
06/27/2024
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