Healthcare Provider Details

I. General information

NPI: 1053725069
Provider Name (Legal Business Name): HANNAH TAFT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1993 ERRECART BLVD
ELKO NV
89801-8334
US

IV. Provider business mailing address

7061 GRAND MONTECITO PKWY
LAS VEGAS NV
89149-0287
US

V. Phone/Fax

Practice location:
  • Phone: 775-753-1049
  • Fax:
Mailing address:
  • Phone: 702-750-3800
  • Fax: 702-750-3853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTRN20444
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17264
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: