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NPI Code Detail

MEDICARE: SUSAN G TAYLOR RN, ARNP, CRNA

MEDICARE:   SUSAN G TAYLOR  RN, ARNP, CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse23815ID
2163W00000XRegistered NurseRN00105586WA
3367500000XCertified Registered Nurse AnesthetistRNA-340ID
4367500000XCertified Registered Nurse AnesthetistAP30005906WA

Other Identifiers

General Provider Information

NPI Number : 1023017043
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN G TAYLOR RN, ARNP, CRNA
Provider Business Mailing Address
First Line : PO BOX 2329
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98273-7329
Country : US
Telephone Number : 509-529-9876
Fax Number : 509-593-5024
Provider Business Practice Location Address
First Line : 1020 SAMISH WAY
Second Line :
City : BELLINGHAM
State : WA
Zip : 98229-3104
Country : US
Telephone Number : 425-231-5293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 12/17/2020

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