Individual
JAMES EDWARD TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54305-3400
(920) 433-5582
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
133217-030
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
3420-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44350900
—
WI
Enumeration date
12/20/2006
Last updated
11/29/2021
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