Provider Demographics
NPI:1619552510
Name:TAYLOR, AMMIE (RN)
Entity Type:Individual
Prefix:
First Name:AMMIE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EVANS ARMY COMMUNITY HOSPITAL
Mailing Address - Street 2:1650 COCHRANE CIRCLE, BLD 7500, RM #3922
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80913
Mailing Address - Country:US
Mailing Address - Phone:719-526-3385
Mailing Address - Fax:719-524-9559
Practice Address - Street 1:1650 COCHRANE CIR BLDG 7500
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80913-4613
Practice Address - Country:US
Practice Address - Phone:719-526-3385
Practice Address - Fax:719-524-9559
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0187981163WM0102X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn