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NPI Code Detail

MEDICARE: TAYLOR MALTBA NP

MEDICARE: TAYLOR MALTBA NP
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 Nurse83499WV
2363LF0000XFamily Nurse Practitioner118490WV

General Provider Information

NPI Number : 1386338531
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MALTBA NP
Provider Business Mailing Address
First Line : 1200 J D ANDERSON DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-3494
Country : US
Telephone Number : 304-598-1200
Fax Number : 304-598-1699
Provider Business Practice Location Address
First Line : 1200 J D ANDERSON DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-3494
Country : US
Telephone Number : 304-598-1200
Fax Number : 304-598-1699
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2023
Last Update Date : 02/09/2026

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Directions to “ TAYLOR MALTBA NP” Practice Location

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