Provider Demographics
NPI:1669966180
Name:TAYLOR, TAQUITA T (APRN, NP)
Entity type:Individual
Prefix:
First Name:TAQUITA
Middle Name:T
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 EMERSON WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-1470
Mailing Address - Country:US
Mailing Address - Phone:317-362-0293
Mailing Address - Fax:317-672-4145
Practice Address - Street 1:5435 EMERSON WAY STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-1470
Practice Address - Country:US
Practice Address - Phone:317-362-0293
Practice Address - Fax:317-744-9556
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28194732A163WH0200X
IN71008741A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH0200XNursing Service ProvidersRegistered NurseHome Health