Healthcare Provider Details

I. General information

NPI: 1669383675
Provider Name (Legal Business Name): TAYLOR TOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N JEFFERSON ST
HOBBS NM
88240-5332
US

IV. Provider business mailing address

2304 DELFINIO DR SE
RIO RANCHO NM
87124-2945
US

V. Phone/Fax

Practice location:
  • Phone: 575-562-0998
  • Fax:
Mailing address:
  • Phone: 505-553-3308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-2026-0034
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: