Provider Demographics
NPI:1245052505
Name:TAYLOR, HEATHER CHRISTINE (LPN)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:CHRISTINE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2673 S 3970 W
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-7746
Mailing Address - Country:US
Mailing Address - Phone:801-380-8347
Mailing Address - Fax:
Practice Address - Street 1:2673 S 3970 W
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-7746
Practice Address - Country:US
Practice Address - Phone:801-380-8347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7861188-3101164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse