Provider Demographics
NPI:1740880343
Name:TAYLOR, NICHOLAS R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:R
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NICK
Other - Middle Name:R
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3555 S 8400 W
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-3458
Mailing Address - Country:US
Mailing Address - Phone:801-601-2838
Mailing Address - Fax:801-601-2841
Practice Address - Street 1:3555 S 8400 W
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-3458
Practice Address - Country:US
Practice Address - Phone:801-601-2838
Practice Address - Fax:801-601-2841
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSI019281183500000X
UT85869221701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist