Provider Demographics
NPI:1518445766
Name:SULA, TAYLOR (DNP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:SULA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:LEGLEITER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 E COURT AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2057
Mailing Address - Country:US
Mailing Address - Phone:515-225-7132
Mailing Address - Fax:515-218-1500
Practice Address - Street 1:13435 UNIVERSITY AVE STE 500
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8251
Practice Address - Country:US
Practice Address - Phone:515-225-7132
Practice Address - Fax:515-218-1500
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH136080363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner