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Individual

MISS KERRY A TALBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
480 PILGRIM WAY # 1300-A, GREEN BAY, WI 54304-5280
(920) 610-5119
(920) 610-5120
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
7439
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7349
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2627165705
PHONE
WI
Enumeration date
10/28/2016
Last updated
05/13/2024
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