Individual
CARLA ELAINE TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
2326 18TH ST, SUITE 210, COLUMBUS, IN 47201-5359
(812) 372-8426
Mailing address
2326 18TH ST, SUITE 210, COLUMBUS, IN 47201-5359
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71004998A
IN
363LA2200X
Adult Health Nurse Practitioner
RN9190141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000990888
ANTHEM PIN
IN
05
—
201340570
—
IN
01
—
GR933Y
WELLMED MEDICAL MANAGEMENT OF FLORIDA INC
—
Enumeration date
06/04/2012
Last updated
04/22/2016
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