Individual
CLAUDIA TALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7030
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 948-7030
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9865
WI
363LF0000X
Family Nurse Practitioner
9865
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100103663
—
WI
Enumeration date
04/18/2020
Last updated
10/23/2023
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