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General NPI Number Information
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NPI Number | 1831565811
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Entity Type | Individual
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Provider Name | TAYLER MARCOLLA N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 801 EUCLID AVE
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City | CAMERON
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State | MO
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Zip | 64429-2003
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Country | US
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Telephone | 816-632-7254
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Fax |
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Provider Business Mailing Address
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Address Line | 2204 RIDGECREST ST
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-3932
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Country | US
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Telephone | 816-262-6919
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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 | 2015021531
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License Number State | MO
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