1730250135 NPI number — MS. JOANNE MARIE TALAREK RN, MSN, C-ANP

Table of content: MS. JOANNE MARIE TALAREK RN, MSN, C-ANP (NPI 1730250135)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730250135 NPI number — MS. JOANNE MARIE TALAREK RN, MSN, C-ANP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TALAREK
Provider First Name:
JOANNE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, C-ANP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MESSINK
Provider Other First Name:
JOANNE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730250135
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39595 W 10 MILE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NOVI
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48375-2948
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-476-6980
Provider Business Mailing Address Fax Number:
248-476-7462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
164 MCLEAN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRUCE TWP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48065-4919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-336-3467
Provider Business Practice Location Address Fax Number:
586-336-3574
Provider Enumeration Date:
11/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  4704104615 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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