Provider Demographics
NPI:1740995216
Name:HILL, TAYLOR ELYSE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELYSE
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W BELTLINE HWY STE 111
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2321
Mailing Address - Country:US
Mailing Address - Phone:608-240-0088
Mailing Address - Fax:
Practice Address - Street 1:2501 W BELTLINE HWY STE 111
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2321
Practice Address - Country:US
Practice Address - Phone:608-240-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI237972-30163WS0121X
WI13307-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI13307-33OtherNURSE PRACTITIONER LICENSE #