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Individual

CASSANDRA M TALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
202 E BAGLEY RD, BEREA, OH 44017-2058
(440) 260-8379
Mailing address
202 E BAGLEY RD, BEREA, OH 44017-2058

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.368951
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21414263
OH
Enumeration date
10/18/2012
Last updated
10/18/2012
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