MEDICARE: TAYLOR KOHDE RACKEY CPM, LDM

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
1	176B00000X	Midwife	LM725	CA

General Provider Information

NPI Number	:	1063133577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR KOHDE RACKEY CPM, LDM

Provider Business Mailing Address
First Line	:	904 W 7TH ST STE 202
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-2737
Country	:	US
Telephone Number	:	530-321-4380
Fax Number	:	775-541-0800

Provider Business Practice Location Address
First Line	:	904 W 7TH ST STE 202
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-2737
Country	:	US
Telephone Number	:	530-321-4380
Fax Number	:	775-541-0800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2022
Last Update Date	:	02/06/2026

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