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General NPI Number Information
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NPI Number | 1922610229
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Entity Type | Individual
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Provider Name | TAYLOR ELIZABETH DAMIANO CNP
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Gender | Female
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 265 WESTERN AVE STE 2
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2458
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Country | US
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Telephone | 207-661-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 265 WESTERN AVE
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2458
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Country | US
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Telephone | 207-661-0200
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN2307119
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | CNP211338
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License Number State | ME
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