Provider Demographics
NPI:1851347215
Name:TAYLOR, JOE E (PMHNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PMHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 PRIDE DR STE B
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-9527
Mailing Address - Country:US
Mailing Address - Phone:985-543-4333
Mailing Address - Fax:985-543-4817
Practice Address - Street 1:835 PRIDE DR STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-9527
Practice Address - Country:US
Practice Address - Phone:985-543-4333
Practice Address - Fax:985-543-4817
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR603538363LF0000X
LAAP02734363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS640507572OLOtherAMERICAN ADMIN GROUP
MS00114278Medicaid
LA1750468Medicaid
500000660Medicare ID - Type Unspecified
MS00114278Medicaid
500011744Medicare ID - Type UnspecifiedRAILROAD MEDICARE