Provider Demographics
NPI:1528603057
Name:VIPOND, TAYLOR ANNE (DNP, FNP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANNE
Last Name:VIPOND
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61362-1517
Mailing Address - Country:US
Mailing Address - Phone:815-664-2366
Mailing Address - Fax:
Practice Address - Street 1:415 E 2ND ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61362-1517
Practice Address - Country:US
Practice Address - Phone:815-664-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.020400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily