Provider Demographics
NPI:1144765041
Name:TAYLOR, ERIK (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2433 NORTHVIEW PL
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-3314
Mailing Address - Country:US
Mailing Address - Phone:435-512-0661
Mailing Address - Fax:
Practice Address - Street 1:2433 NORTHVIEW PL
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-3314
Practice Address - Country:US
Practice Address - Phone:435-512-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1631783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse