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General NPI Number Information
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NPI Number | 1477384584
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Entity Type | Individual
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Provider Name | DESTINY MARIE TAYLOR FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2024
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 12500 DALLAS PKWY STE 4.200
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City | FRISCO
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State | TX
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Zip | 75033-4231
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Country | US
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Telephone | 214-618-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 12500 DALLAS PKWY STE 4.200
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City | FRISCO
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State | TX
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Zip | 75033-4231
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Country | US
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Telephone | 214-618-7100
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Fax | 214-618-7101
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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 | 1171103
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License Number State | TX
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