Provider Demographics
NPI:1669267845
Name:KNOX, TAYTUM
Entity type:Individual
Prefix:
First Name:TAYTUM
Middle Name:
Last Name:KNOX
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 MOUNES ST APT R362
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD
Mailing Address - State:LA
Mailing Address - Zip Code:70123-6243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6221 S CLAIBORNE AVE STE 537
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4142
Practice Address - Country:US
Practice Address - Phone:833-342-1454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN296499163W00000X
NY976889163W00000X
LARN238862163W00000X
CA95407982163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse