Healthcare Provider Details

I. General information

NPI: 1619552510
Provider Name (Legal Business Name): AMMIE TAYLOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR BLDG 7500
COLORADO SPRINGS CO
80913-4613
US

IV. Provider business mailing address

EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIRCLE, BLD 7500, RM #3922
COLORADO SPRINGS CO
80913
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-3385
  • Fax: 719-524-9559
Mailing address:
  • Phone: 719-526-3385
  • Fax: 719-524-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number0187981
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0187981
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: