Provider Demographics
NPI:1083383558
Name:TAYLOR, DANANGE MARCHELL (FNP)
Entity Type:Individual
Prefix:MS
First Name:DANANGE
Middle Name:MARCHELL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:FNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-2280
Mailing Address - Fax:888-352-8360
Practice Address - Street 1:1255 GRAHAM RD
Practice Address - Street 2:DIV SURG HPB
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8014
Practice Address - Country:US
Practice Address - Phone:314-362-2280
Practice Address - Fax:888-352-8360
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2020010573363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420120257Medicaid