Provider Demographics
NPI:1043988520
Name:TAYLOR, NICOLE MICHELLE (RN)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MICHELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 VALENCIA
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-5691
Mailing Address - Country:US
Mailing Address - Phone:520-784-3986
Mailing Address - Fax:
Practice Address - Street 1:852 VALENCIA
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5691
Practice Address - Country:US
Practice Address - Phone:520-784-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM63742163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WF0300XNursing Service ProvidersRegistered NurseFlight