Provider Demographics
NPI:1407252315
Name:VALDETERO, TAYLOR (FNP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:VALDETERO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ANGELLE
Other - Last Name:CART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1307 CROWLEY RAYNE HWY STE E
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-8210
Mailing Address - Country:US
Mailing Address - Phone:337-210-4045
Mailing Address - Fax:
Practice Address - Street 1:1307 CROWLEY RAYNE HWY STE E
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526
Practice Address - Country:US
Practice Address - Phone:225-572-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07111363LA2100X, 363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health