Provider Demographics
NPI:1386196483
Name:TAYLOR, CATHERINE ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 BIRCH ST
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2127
Mailing Address - Country:US
Mailing Address - Phone:888-835-0894
Mailing Address - Fax:
Practice Address - Street 1:121 WHITESELL ST NE
Practice Address - Street 2:
Practice Address - City:ORTING
Practice Address - State:WA
Practice Address - Zip Code:98360-8410
Practice Address - Country:US
Practice Address - Phone:360-893-6500
Practice Address - Fax:360-893-4367
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00050113164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse