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General NPI Number Information
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NPI Number | 1891130761
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Entity Type | Individual
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Provider Name | IAN DALTON TAYLOR MSN, APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 05/06/2013
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 642 ULUKAHIKI ST STE 300
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City | KAILUA
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State | HI
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Zip | 96734-4439
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Country | US
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Telephone | 808-261-4476
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Fax | 808-263-4476
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Provider Business Mailing Address
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Address Line | 353 MALUNIU AVE
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City | KAILUA
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State | HI
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Zip | 96734-2370
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Country | US
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Telephone | 808-286-3274
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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 | APRN 1567
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License Number State | HI
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