Provider Demographics
NPI:1376021477
Name:TAUB, KRISTEN ERICA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ERICA
Last Name:TAUB
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 N JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-1027
Mailing Address - Country:US
Mailing Address - Phone:970-397-4836
Mailing Address - Fax:
Practice Address - Street 1:213 N JAMES ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1027
Practice Address - Country:US
Practice Address - Phone:970-397-4836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201806066NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily