Healthcare Provider Details

I. General information

NPI: 1942771365
Provider Name (Legal Business Name): TAYLOR ELISE MCCOMB CAMPBELL CBD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N CARRIAGE HILL DR UNIT 1145
LAS VEGAS NV
89138-4743
US

IV. Provider business mailing address

600 N CARRIAGE HILL DR UNIT 1145
LAS VEGAS NV
89138-4743
US

V. Phone/Fax

Practice location:
  • Phone: 702-303-2419
  • Fax:
Mailing address:
  • Phone: 702-303-2419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: