Provider Demographics
NPI:1851881213
Name:HUINKER, TAYLOR J (FNP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:J
Last Name:HUINKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:J
Other - Last Name:RUSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:190 CAMPUS BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2872
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2926
Practice Address - Country:US
Practice Address - Phone:641-494-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176114363L00000X
IAA168695363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA168695OtherNURSE PRACTITIONER
VA0024176114OtherNURSE PRACTITIONER