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General NPI Number Information
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NPI Number | 1659298594
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Entity Type | Individual
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Provider Name | TAYLOR SMITH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 3267 N EVERGREEN DR NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525
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Country | US
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Telephone | 616-217-3632
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Fax |
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Provider Business Mailing Address
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Address Line | 6450 ESTATE DR SW
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City | BYRON CENTER
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State | MI
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Zip | 49315-9617
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Country | US
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Telephone | 616-217-3632
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 4704358825
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License Number State | MI
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