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General NPI Number Information
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NPI Number | 1699419465
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Entity Type | Individual
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Provider Name | CASSANDRA TAYLOR
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Gender | Female
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 07/04/2022
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Provider Practice Location Address
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Address Line | 601 W LEOTA ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6525
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Country | US
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Telephone | 308-568-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 7456 S HOMAN PL UNIT 13
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City | SIOUX FALLS
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State | SD
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Zip | 57108-8521
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Country | US
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Telephone | 816-560-6655
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R051790
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95221
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 101717
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License Number State | NE
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