Provider Demographics
NPI:1649759069
Name:TAYLOR, JAMES C (APRN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3396 S MEADOW CLOVER CT
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84128-7808
Mailing Address - Country:US
Mailing Address - Phone:801-520-1363
Mailing Address - Fax:
Practice Address - Street 1:5848 S FASHION BLVD # 300E
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6170
Practice Address - Country:US
Practice Address - Phone:801-314-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT308782-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily