Provider Demographics
NPI:1679930143
Name:REECE, TALIA NICOLE (FNP)
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:NICOLE
Last Name:REECE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 PRIMACY PKWY
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5763
Mailing Address - Country:US
Mailing Address - Phone:901-767-1040
Mailing Address - Fax:901-685-7362
Practice Address - Street 1:6025 PRIMACY PKWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5763
Practice Address - Country:US
Practice Address - Phone:901-767-1040
Practice Address - Fax:901-685-7362
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN20897OtherTN NP LICENSE