Individual
MRS. SUE MCKENZIE TALBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDE LDN
Contact information
Practice address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505-5515
(616) 774-8789
Mailing address
612 COLLEGE STREET, JACKSONVILLE, NC 28540
(910) 347-2154
(910) 347-2789
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L001793
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
710000239
MEDICARE RAILROAD CARRIER
NC
Enumeration date
09/20/2006
Last updated
02/02/2021
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