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General NPI Number Information
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NPI Number | 1568285229
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Entity Type | Individual
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Provider Name | NICOLE MARIE TAYLOR NP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 4404 WI-70
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City | WEBSTER
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State | WI
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Zip | 54893
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Country | US
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Telephone | 715-349-8554
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 454
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City | FREDERIC
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State | WI
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Zip | 54837-0454
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Country | US
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Telephone | 715-222-8774
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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 | 12037
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 15820-33
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License Number State | WI
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