=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174987432
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICOLE A. TAYLOR PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2016
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 MCKOWN RD STE 102
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12203-3473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-689-0244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 MANOR AVE
-----------------------------------------------------
City | COHOES
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12047-1519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-334-1538
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 491467
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | F405061-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------