Provider Demographics
NPI:1063772440
Name:TAYLOR, BEATRICE V (DO)
Entity type:Individual
Prefix:DR
First Name:BEATRICE
Middle Name:V
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:NE
Mailing Address - Zip Code:69343-1123
Mailing Address - Country:US
Mailing Address - Phone:402-302-8666
Mailing Address - Fax:308-282-1428
Practice Address - Street 1:300 E 8TH ST
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:NE
Practice Address - Zip Code:69343-1123
Practice Address - Country:US
Practice Address - Phone:308-282-0401
Practice Address - Fax:308-282-1428
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0075811208D00000X
NE1559208D00000X
TXQ2075208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE388381Medicare PIN
TX388381Medicare PIN