Provider Demographics
NPI:1124612411
Name:CAWTHON, TALENA M
Entity type:Individual
Prefix:
First Name:TALENA
Middle Name:M
Last Name:CAWTHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12691 WEEPING BRANCH CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-9618
Mailing Address - Country:US
Mailing Address - Phone:904-330-6064
Mailing Address - Fax:
Practice Address - Street 1:12691 WEEPING BRANCH CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-9618
Practice Address - Country:US
Practice Address - Phone:904-330-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula