Provider Demographics
NPI:1922991959
Name:IPOCK, TAYLOR RENEE (CHES)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RENEE
Last Name:IPOCK
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 3RD AVE APT 402
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4193
Mailing Address - Country:US
Mailing Address - Phone:918-636-1426
Mailing Address - Fax:
Practice Address - Street 1:400 E 3RD AVE APT 402
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4193
Practice Address - Country:US
Practice Address - Phone:918-636-1426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
22101174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator