Healthcare Provider Details

I. General information

NPI: 1265105860
Provider Name (Legal Business Name): TAYLOR BECIREVIC NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 FOREST DR
FRANKFORT IN
46041-3223
US

IV. Provider business mailing address

859 FOREST DR
FRANKFORT IN
46041-3223
US

V. Phone/Fax

Practice location:
  • Phone: 765-242-8682
  • Fax:
Mailing address:
  • Phone: 765-242-8682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71011402A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28243048A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71011402A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: