Provider Demographics
NPI:1013945302
Name:TAYLOR, VIRGINIA J (CFNP)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:J
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:MS
Other - First Name:GINGER
Other - Middle Name:J
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CFNP
Mailing Address - Street 1:1100 7TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1925
Mailing Address - Country:US
Mailing Address - Phone:541-812-4980
Mailing Address - Fax:541-926-9329
Practice Address - Street 1:1100 7TH AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1925
Practice Address - Country:US
Practice Address - Phone:541-812-4980
Practice Address - Fax:541-926-9329
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR094006513RN/N1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR99541Medicare UPIN