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General NPI Number Information
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NPI Number | 1851635114
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Entity Type | Individual
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Provider Name | CASIE TAYLOR FNP
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Gender | Female
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1218 9TH ST STE 10
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City | RUPERT
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State | ID
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Zip | 83350-2207
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Country | US
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Telephone | 208-464-8420
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Fax | 208-436-3956
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Provider Business Mailing Address
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Address Line | 1224 8TH STREET
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City | RUPERT
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State | ID
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Zip | 83350-1527
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Country | US
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Telephone | 208-434-8236
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Fax | 208-436-6038
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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 | NP-1188A
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License Number State | ID
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