Provider Demographics
NPI:1821600982
Name:POPP, TAYLOR ANN (NP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:POPP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S STATE ROAD 57 STE A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-4371
Mailing Address - Country:US
Mailing Address - Phone:812-257-1052
Mailing Address - Fax:812-996-7649
Practice Address - Street 1:600 S STATE ROAD 57
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-4371
Practice Address - Country:US
Practice Address - Phone:812-257-1052
Practice Address - Fax:812-996-7649
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INPENDING363LP2300X
IN71010395A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care