Provider Demographics
NPI:1013326024
Name:CLAYBROOK, TAYLOR L (MSN, RN)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:L
Last Name:CLAYBROOK
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:L
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1705 EAST 19TH ST, SET 302
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104
Mailing Address - Country:US
Mailing Address - Phone:918-748-7599
Mailing Address - Fax:
Practice Address - Street 1:1705 E 19TH ST # ST302
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5405
Practice Address - Country:US
Practice Address - Phone:918-748-7599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0101777163W00000X
OK101777363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse