Provider Demographics
NPI:1134780141
Name:GRINSTEAD, TAYLOR NICOLE (DNP)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:NICOLE
Last Name:GRINSTEAD
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:DR
Other - First Name:TAYLOR
Other - Middle Name:NICOLE
Other - Last Name:FASSBINDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 974
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:IA
Mailing Address - Zip Code:52052-0974
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MAIN ST
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:IA
Practice Address - Zip Code:52052-9108
Practice Address - Country:US
Practice Address - Phone:563-252-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA155088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily