Provider Demographics
NPI:1326063884
Name:TAYLOR, DELLA V (APRN-BC)
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:V
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HEARTLAND RD STE 2800
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-6201
Mailing Address - Country:US
Mailing Address - Phone:816-271-1200
Mailing Address - Fax:
Practice Address - Street 1:901 HEARTLAND RD STE 2800
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-6201
Practice Address - Country:US
Practice Address - Phone:816-271-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO099878207VG0400X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00036092OtherRAILROAD MEDICARE
KS100358460BMedicaid
440545289H010OtherTRICARE/CHAMPUS
MO429751506Medicaid
S03492Medicare UPIN
440545289H010OtherTRICARE/CHAMPUS
701A549Medicare ID - Type Unspecified