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Individual

DR. ANGELLA MARIE TALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
01061972A
IN
208000000X
Pediatrics Physician
Primary
40534
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200847430
IN
05
7100206000
KY
Enumeration date
09/20/2006
Last updated
12/30/2020
Update your record

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