Healthcare Provider Details

I. General information

NPI: 1710252416
Provider Name (Legal Business Name): TAYLOR FIRST ASSISTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 N TEJON ST
COLORADO SPRINGS CO
80907-6835
US

IV. Provider business mailing address

2412 N TEJON ST
COLORADO SPRINGS CO
80907-6835
US

V. Phone/Fax

Practice location:
  • Phone: 719-238-2920
  • Fax: 719-475-8313
Mailing address:
  • Phone: 719-238-2920
  • Fax: 719-475-8313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN117681
License Number StateCO

VIII. Authorized Official

Name: MR. JESSE TAYLOR JR.
Title or Position: OWNER
Credential: RNFA
Phone: 719-238-2920