Healthcare Provider Details

I. General information

NPI: 1003600529
Provider Name (Legal Business Name): TAYLOR CULLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 MAIN ST STE B101
EVANSVILLE IN
47708-2400
US

IV. Provider business mailing address

1826 TANGLEWOOD DR
MOUNT VERNON IN
47620-8213
US

V. Phone/Fax

Practice location:
  • Phone: 812-492-5715
  • Fax:
Mailing address:
  • Phone: 812-205-3995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28262775A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number71017079A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: