Healthcare Provider Details

I. General information

NPI: 1992536999
Provider Name (Legal Business Name): TAYLOR PAIGE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6551 S REVERE PKWY
CENTENNIAL CO
80111-6409
US

IV. Provider business mailing address

4247 PARKWOOD TRL
COLORADO SPRINGS CO
80918-7709
US

V. Phone/Fax

Practice location:
  • Phone: 806-236-8372
  • Fax:
Mailing address:
  • Phone: 806-236-8372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN.1001808-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1168482
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: