Healthcare Provider Details

I. General information

NPI: 1861186918
Provider Name (Legal Business Name): TAYLOR CORNWELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR CORNWELL-HINRICHS DO

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E WOODMEN RD
COLORADO SPRINGS CO
80923-2601
US

IV. Provider business mailing address

6001 E WOODMEN RD
COLORADO SPRINGS CO
80923-2601
US

V. Phone/Fax

Practice location:
  • Phone: 619-764-9654
  • Fax:
Mailing address:
  • Phone: 619-764-9654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDR.0077097
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number000000
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR4137
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: