Provider Demographics
NPI:1801512322
Name:TAYLOR, KIRSTEN (DC)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15733 EUSTONE TER
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-1959
Mailing Address - Country:US
Mailing Address - Phone:817-905-5048
Mailing Address - Fax:
Practice Address - Street 1:7500 BOULEVARD 26
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8318
Practice Address - Country:US
Practice Address - Phone:817-259-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor