Provider Demographics
NPI:1184442568
Name:HALL, TAYLOR RENEE (FNP BC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RENEE
Last Name:HALL
Suffix:
Gender:F
Credentials:FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 PAULS DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-1152
Mailing Address - Country:US
Mailing Address - Phone:317-590-7433
Mailing Address - Fax:
Practice Address - Street 1:9535 E 151ST ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-0050
Practice Address - Country:US
Practice Address - Phone:317-523-9160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015799A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily