Healthcare Provider Details

I. General information

NPI: 1649369869
Provider Name (Legal Business Name): ANNA TAYLOR CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 5TH AVE
SPOKANE WA
99202-1334
US

IV. Provider business mailing address

PO BOX 3649
SPOKANE WA
99220-3649
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-2531
  • Fax: 509-755-6580
Mailing address:
  • Phone: 509-838-2531
  • Fax: 509-838-2531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704275881
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60660380
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: