Healthcare Provider Details

I. General information

NPI: 1548367451
Provider Name (Legal Business Name): TAUNYA EYRE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W DAFFODIL CT
HENDERSON KY
42420-3485
US

IV. Provider business mailing address

2525 W DAFFODIL CT
HENDERSON KY
42420-3485
US

V. Phone/Fax

Practice location:
  • Phone: 270-826-4539
  • Fax: 270-826-9074
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1078744
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: