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NPI Code Detail

MEDICARE: TINA M TAYLOR ARNP

MEDICARE: TINA M TAYLOR ARNP
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
1163WP0809XAdult Psychiatric/Mental Health Registered NurseRN00113328WA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAP30006904WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28901809OTHERWACRIME VICTIMS

General Provider Information

NPI Number : 1306832274
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA M TAYLOR ARNP
Provider Business Mailing Address
First Line : PO BOX 2429
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-8486
Country : US
Telephone Number : 360-575-8275
Fax Number : 360-575-1950
Provider Business Practice Location Address
First Line : 945 11TH AVE STE B
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2555
Country : US
Telephone Number : 360-414-8600
Fax Number : 360-636-7372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 01/05/2022

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