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General NPI Number Information
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NPI Number | 1447913835
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Entity Type | Individual
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Provider Name | TAYLOR PENICK APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 6611 RIVER PLACE BLVD STE 202
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City | AUSTIN
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State | TX
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Zip | 78730-1167
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Country | US
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Telephone | 512-473-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 3456 N HILLS DR APT 116
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City | AUSTIN
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State | TX
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Zip | 78731-3169
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Country | US
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Telephone | 256-783-4772
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1035103
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License Number State | TX
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