Provider Demographics
NPI:1477547172
Name:TAYLOR, CHRISTA T (APRN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:T
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:2914 SW PLASS CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-1925
Mailing Address - Country:US
Mailing Address - Phone:785-233-7138
Mailing Address - Fax:785-233-7089
Practice Address - Street 1:2914 SW PLASS CT
Practice Address - Street 2:SUITE D
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-1925
Practice Address - Country:US
Practice Address - Phone:785-233-7138
Practice Address - Fax:785-233-7089
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45247363LP0808X
KS53-45247-062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100407150EMedicaid
KS003734005Medicare PIN