Provider Demographics
NPI:1548774680
Name:TAGGART, ELIZABETH D (APRN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:TAGGART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 DOGWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-9013
Mailing Address - Country:US
Mailing Address - Phone:316-209-7987
Mailing Address - Fax:
Practice Address - Street 1:2117 KEYSTONE CIR
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-8749
Practice Address - Country:US
Practice Address - Phone:316-733-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS91796163W00000X
KS53-77986-091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse