Healthcare Provider Details

I. General information

NPI: 1073087524
Provider Name (Legal Business Name): TAYLOR BYRD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2019
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S 500 E
SALT LAKE CITY UT
84102-2753
US

IV. Provider business mailing address

455 S 500 E
SALT LAKE CITY UT
84102-2753
US

V. Phone/Fax

Practice location:
  • Phone: 801-328-6033
  • Fax: 801-328-6027
Mailing address:
  • Phone: 334-405-3607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number12552720-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: