| Jennifer Talley, PMHNP | |
|
28 Letnikof Rd, Haines, AK 99827-9982 | |
| (907) 314-0864 | |
| Not Available |
| Full Name | Jennifer Talley |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 28 Letnikof Rd, Haines, Alaska |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699498055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WP0808X | Registered Nurse - Psychiatric/mental Health | 24512 (Alaska) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 211006 (Alaska) | Primary |
| Entity Name | Identity Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225633449 PECOS PAC ID: 5395150460 Enrollment ID: O20210223001828 |
| Entity Name | Ketamine Wellness Institute, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740066216 PECOS PAC ID: 4789038928 Enrollment ID: O20230921003948 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Talley, PMHNP Po Box 1086, Haines, AK 99827-1086 Ph: (907) 314-0864 | Jennifer Talley, PMHNP 28 Letnikof Rd, Haines, AK 99827-9982 Ph: (907) 314-0864 |
Mrs. Pornson P Linton, ANP (FNP) Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1549 Second St., Haines, AK 99827 Phone: 907-766-6374 Fax: 907-766-3643 | |
Mrs. Rebecca Sue Malone, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 131 1st Avenue South, Haines, AK 99827 Phone: 907-766-6300 Fax: 907-766-3643 |