MEDICARE: DELLA V TAYLOR APRN-BC

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	207VG0400X	Gynecology Physician	099878	MO
2	363LF0000X	Family Nurse Practitioner	099878	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00036092	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	440545289H010	OTHER	TRICARE/CHAMPUS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326063884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELLA V TAYLOR APRN-BC

Provider Business Mailing Address
First Line	:	901 HEARTLAND RD STE 2800
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-6201
Country	:	US
Telephone Number	:	816-271-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 HEARTLAND RD STE 2800
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-6201
Country	:	US
Telephone Number	:	816-271-1200
Fax Number	:

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	03/17/2018

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Directions to “ DELLA V TAYLOR APRN-BC” Practice Location

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