Provider Demographics
NPI:1972082097
Name:TALBERT, KIM WEBB (NP)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:WEBB
Last Name:TALBERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:YVETTE
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 PROVIDENCE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207
Mailing Address - Country:US
Mailing Address - Phone:704-749-5800
Mailing Address - Fax:704-626-3049
Practice Address - Street 1:NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER CHARLOTTE
Practice Address - Street 2:200 HAWTHORNE LANE
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204
Practice Address - Country:US
Practice Address - Phone:704-384-4028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010813363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner