Provider Demographics
NPI:1003683442
Name:POWELL-REES, TAYLOR T
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:T
Last Name:POWELL-REES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 S GOLDEN CIR
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1422
Mailing Address - Country:US
Mailing Address - Phone:208-240-6058
Mailing Address - Fax:
Practice Address - Street 1:450 FALLS AVE STE 106
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-2307
Practice Address - Country:US
Practice Address - Phone:208-595-5045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care