MEDICARE: LAURA K TAYLOR

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1417559279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA K TAYLOR

Provider Business Mailing Address
First Line	:	13031 SANDIA POINT RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-8321
Country	:	US
Telephone Number	:	816-304-8847
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 SAN PEDRO DR SE BLDG 41
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-5153
Country	:	US
Telephone Number	:	505-846-1483
Fax Number	:

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

Provider Enumeration Date	:	11/16/2020
Last Update Date	:	06/18/2026

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Directions to “ LAURA K TAYLOR ” Practice Location

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