Healthcare Provider Details

I. General information

NPI: 1548118391
Provider Name (Legal Business Name): TAYLOR MILSTEADT APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR FLAIRTY

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 N STATE ROUTE 91
PEORIA IL
61615-9541
US

IV. Provider business mailing address

8600 N STATE ROUTE 91
PEORIA IL
61615-9541
US

V. Phone/Fax

Practice location:
  • Phone: 309-655-7668
  • Fax: 309-655-3948
Mailing address:
  • Phone: 309-655-7668
  • Fax: 309-655-3948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209035299
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041474686
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: