Provider Demographics
NPI:1073393930
Name:LYLE, TAYLOR LYNAE (ND)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:LYNAE
Last Name:LYLE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 W CHANDLER BLVD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3689
Mailing Address - Country:US
Mailing Address - Phone:480-219-9900
Mailing Address - Fax:
Practice Address - Street 1:5510 W CHANDLER BLVD UNIT 3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3689
Practice Address - Country:US
Practice Address - Phone:480-219-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23-1811175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath