Provider Demographics
NPI:1386655090
Name:TAYLOR, CHRISTINE M (RNFAFNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RNFAFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 HAMILTON WAY
Mailing Address - Street 2:SUITE106
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-6831
Mailing Address - Country:US
Mailing Address - Phone:325-245-4511
Mailing Address - Fax:
Practice Address - Street 1:2141 HAMILTON WAY
Practice Address - Street 2:SUITE106
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-6831
Practice Address - Country:US
Practice Address - Phone:325-245-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX660848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89N965OtherBLUE CROSS BLUE SHIELD