Individual
MARY ELIZABETH TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
50 UNION ST, MAINE COAST MEMORIAL HOSPITAL, ELLSWORTH, ME 04605-1586
(207) 664-5304
(207) 664-5305
Mailing address
50 UNION ST, MAINE COAST MEMORIAL HOSPITAL, ELLSWORTH, ME 04605-1586
(207) 664-5304
(207) 664-5305
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN037150
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000748371B
—
GA
Enumeration date
11/22/2005
Last updated
08/05/2008
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