Healthcare Provider Details

I. General information

NPI: 1326799016
Provider Name (Legal Business Name): TAYLOR ANN STOCKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2022
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 STONE ST STE 3
PORT HURON MI
48060-3563
US

IV. Provider business mailing address

1201 STONE ST STE 3
PORT HURON MI
48060-3563
US

V. Phone/Fax

Practice location:
  • Phone: 810-985-5000
  • Fax:
Mailing address:
  • Phone: 810-985-5000
  • Fax: 810-985-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704273942
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: