Individual
MRS. MARY MAGDELINE TALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
6109 HEATHBROOK LN, KERNERSVILLE, NC 27284-8715
(336) 564-6025
Mailing address
6109 HEATHBROOK LN, KERNERSVILLE, NC 27284-8715
(336) 564-6025
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
587348
NC
Other
Enumeration date
04/18/2024
Last updated
04/22/2024
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