Individual
EBONE L TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2779 MERRIWEATHER ST NW, WARREN, OH 44485-2508
(234) 719-9485
Mailing address
2779 MERRIWEATHER ST NW, WARREN, OH 44485-2508
(234) 719-9485
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN 164558
OH
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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