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General NPI Number Information
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NPI Number | 1295291102
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Entity Type | Organization
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Legal Business Name | NEW HORIZONS NICHOLE TAYLOR PMHNP-BC
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Dates
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Enumeration Date | 02/15/2019
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 2001 W LAKEWAY RD STE C
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City | GILLETTE
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State | WY
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Zip | 82718-5774
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Country | US
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Telephone | 307-670-8048
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Fax | 949-404-6138
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Provider Business Mailing Address
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Address Line | 2001 W LAKEWAY RD STE C
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City | GILLETTE
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State | WY
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Zip | 82718-5774
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Country | US
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Telephone | 307-670-8048
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Fax | 949-404-6138
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLE M TAYLOR
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Credential | PMHNP-BC
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Telephone | 307-363-0883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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