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General NPI Number Information
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NPI Number | 1912554817
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Entity Type | Individual
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Provider Name | TAYLOR PIONTEK NP-C
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Gender | Male
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Dates
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Enumeration Date | 08/25/2019
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 1101 N CENTRAL AVE STE 200
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City | PHOENIX
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State | AZ
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Zip | 85004-1844
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Country | US
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Telephone | 602-307-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 3240 E PINCHOT AVE UNIT 13
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City | PHOENIX
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State | AZ
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Zip | 85018-6994
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Country | US
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Telephone | 417-437-8152
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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 | 230152
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License Number State | AZ
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