Healthcare Provider Details

I. General information

NPI: 1689589160
Provider Name (Legal Business Name): TAYLOR HEADLOUGH CNM, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 S MILL AVE
TEMPE AZ
85281-8685
US

IV. Provider business mailing address

362 E WELDON AVE
PHOENIX AZ
85012-2005
US

V. Phone/Fax

Practice location:
  • Phone: 480-647-2099
  • Fax:
Mailing address:
  • Phone: 480-309-4345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number342180
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: