Healthcare Provider Details

I. General information

NPI: 1164033635
Provider Name (Legal Business Name): LAUREN NICOLE TAYLOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N GRAND AVE
GAINESVILLE TX
76240-3573
US

IV. Provider business mailing address

801 N GRAND AVE
GAINESVILLE TX
76240-3573
US

V. Phone/Fax

Practice location:
  • Phone: 940-612-8750
  • Fax: 940-668-3048
Mailing address:
  • Phone: 940-612-8750
  • Fax: 940-668-3048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1007574
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: