=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003648213
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAYLOR MICHELLE OBERG RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2024
-----------------------------------------------------
Last Update Date | 08/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 372 SW 4TH AVE
-----------------------------------------------------
City | OAK HARBOR
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-389-4149
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 372 SW 4TH AVE
-----------------------------------------------------
City | OAK HARBOR
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98277
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-389-4149
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | ARNP.AP.70163523-CNM
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN61191884
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | ARNP.AP.70163523-CNM
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------