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General NPI Number Information
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NPI Number | 1740938315
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Entity Type | Individual
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Provider Name | TAYLOR ALEXANDER MCGOVERN MSN, APRN, FNP
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Gender | Male
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 1600 E BROADWAY
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City | COLUMBIA
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State | MO
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Zip | 65201-5844
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Country | US
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Telephone | 573-815-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 19400 EAST 37TH STREET TERRACE COURT SOUTH APARTMENT 211
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City | INDEPENDENCE
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State | MO
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Zip | 64057
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Country | US
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Telephone | 660-351-6127
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2022008246
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License Number State | MO
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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 | F02221007
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License Number State | MO
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