TAYLOR, ALICE B (CNM NP)

Provider Demographics

• NPI: 1558347781
• Name: TAYLOR, ALICE B (CNM NP)
• Entity Type: Individual
• First Name: ALICE
• Middle Name: B
• Last Name: TAYLOR
• Gender: F
• Credentials: CNM NP
• Mailing Address - Street 1: PO BOX 1710
• Mailing Address - City: GOLD BEACH
• Mailing Address - State: OR
• Mailing Address - Zip Code: 97444
• Mailing Address - Country: US
• Mailing Address - Phone: 541-425-5311
• Mailing Address - Fax: 541-425-5577
• Practice Address - Street 1: 29135 ELLENSBURG AVE
• Practice Address - City: GOLD BEACH
• Practice Address - State: OR
• Practice Address - Zip Code: 97444
• Practice Address - Country: US
• Practice Address - Phone: 541-425-5311
• Practice Address - Fax: 541-425-5577
• Is Sole Proprietor?: No
• Enumeration Date: 2005-12-20
• Last Update Date: 2015-04-03

Provider Licenses

State	License ID	Taxonomies
OR	000031286N5	363L00000X, 367A00000X
OR	A000031286N5	367A00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	367A00000X	Physician Assistants & Advanced Practice Nursing Providers	Advanced Practice Midwife
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner

Provider Identifiers

State	Identifier ID	ID Type	Issuer
OR	172189	Medicaid
OR	1386069326	Other	BRIGHT EYES MIDWIFERY & WILD RIVERS WOMEN'S HEALTH LLC NPI
OR	381322	Other	CURRY GENERAL HOSP. - PART A
OR	R179539	Other	BRIGHT EYES MIDWIFERY & WILD RIVERS WOMEN'S HEALTH, LLC PTAN
OR	R179539	Other	BRIGHT EYES MIDWIFERY & WILD RIVERS WOMEN'S HEALTH, LLC PTAN
OR	46-4734811	Other	BRIGHT EYES MIDWIFERY & WILD RIVERS WOMEN'S HEALTH LLC TIN
OR	R153858	Medicare PIN
OR	381322	Other	CURRY GENERAL HOSP. - PART A
OR	523030004	Other	BCBS OF OR
OR	383853	Medicare Oscar/Certification
OR	0577260001	Medicare NSC
OR	R153858	Medicare PIN
	1235145624	Other	CURRY WOMENS CLINIC NPI
OR	1487696985	Other	CGH NPI NUMBER
OR	381322	Other	CURRY GENERAL HOSP. - PART A