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General NPI Number Information
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NPI Number | 1497579049
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Entity Type | Individual
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Provider Name | TAYLOR RENAE GARCIA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 315 E ELM ST # 201
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City | CALDWELL
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State | ID
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Zip | 83605-4857
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Country | US
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Telephone | 208-514-2528
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Fax | 208-375-2217
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Provider Business Mailing Address
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Address Line | 777 N RAYMOND ST
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City | BOISE
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State | ID
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Zip | 83704-9251
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Country | US
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Telephone | 208-514-2500
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Fax | 208-375-2217
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | AP61628105
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1271066
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License Number State | ID
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