Healthcare Provider Details

I. General information

NPI: 1700790219
Provider Name (Legal Business Name): DANIEL TAYLOR FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BELLINGER ST
EAU CLAIRE WI
54703-9943
US

IV. Provider business mailing address

1704 SIERRA DR S
EAU CLAIRE WI
54701-7993
US

V. Phone/Fax

Practice location:
  • Phone: 715-838-3242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberF09261574
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: