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General NPI Number Information
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NPI Number | 1841951993
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Entity Type | Individual
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Provider Name | JACINDA TAYLOR PHARMD.
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Gender | Female
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Dates
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Enumeration Date | 12/30/2021
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 622 E USTICK RD
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City | CALDWELL
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State | ID
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Zip | 83605-6311
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Country | US
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Telephone | 208-453-2852
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Fax |
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Provider Business Mailing Address
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Address Line | 921 W 2ND ST
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City | MERIDIAN
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State | ID
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Zip | 83642-2213
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Country | US
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Telephone | 406-460-0474
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 83265
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P9807
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License Number State | ID
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