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General NPI Number Information
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NPI Number | 1154965705
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Entity Type | Individual
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Provider Name | TAYLOR NICOLE PEPPER
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Gender | Female
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 431 HOMER RD
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City | MINDEN
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State | LA
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Zip | 71055-2993
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Country | US
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Telephone | 318-377-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 437 PEPPER LN
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City | EL DORADO
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State | AR
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Zip | 71730-9028
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Country | US
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Telephone | 870-315-2886
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R108635
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 222181
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License Number State | LA
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