Healthcare Provider Details

I. General information

NPI: 1831883214
Provider Name (Legal Business Name): TAYLOR ESTERS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR BREWER

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4702 MONROE HWY
BALL LA
71405-3944
US

IV. Provider business mailing address

4702 MONROE HWY
BALL LA
71405-3944
US

V. Phone/Fax

Practice location:
  • Phone: 318-641-6113
  • Fax: 318-641-6115
Mailing address:
  • Phone: 318-641-6113
  • Fax: 318-641-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number230612
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: