Provider Demographics
NPI:1467921601
Name:MCARTHUR, TAYLER BROOKE (NP)
Entity Type:Individual
Prefix:
First Name:TAYLER
Middle Name:BROOKE
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TAYLER
Other - Middle Name:BROOKE
Other - Last Name:KERNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1228 1ST AVE E
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-3160
Mailing Address - Country:US
Mailing Address - Phone:276-639-9192
Mailing Address - Fax:
Practice Address - Street 1:610 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2589
Practice Address - Country:US
Practice Address - Phone:276-525-1586
Practice Address - Fax:276-525-1609
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176909363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024176909OtherLICENSED NURSE PRACTITIONER