MEDICARE: NIKKI MICHELLE TAYLOR APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	A02919	AR
2	363L00000X	Nurse Practitioner	A02919	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124132550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKKI MICHELLE TAYLOR APN

Provider Business Mailing Address
First Line	:	2900 HAWKINS DR
Second Line	:
City	:	SEARCY
State	:	AR
Zip	:	72143-4802
Country	:	US
Telephone Number	:	501-279-9393
Fax Number	:	501-279-9073

Provider Business Practice Location Address
First Line	:	711 SANTA FE DR
Second Line	:
City	:	SEARCY
State	:	AR
Zip	:	72143-6964
Country	:	US
Telephone Number	:	501-279-9393
Fax Number	:	501-279-9073

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	09/25/2024

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