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General NPI Number Information
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NPI Number | 1306832274
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Entity Type | Individual
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Provider Name | TINA M TAYLOR ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 945 11TH AVE STE B
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City | LONGVIEW
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State | WA
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Zip | 98632-2555
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Country | US
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Telephone | 360-414-8600
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Fax | 360-636-7372
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Provider Business Mailing Address
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Address Line | PO BOX 2429
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City | LONGVIEW
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State | WA
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Zip | 98632-8486
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Country | US
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Telephone | 360-575-8275
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Fax | 360-575-1950
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN00113328
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP30006904
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License Number State | WA
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