Provider Demographics
NPI:1861379521
Name:EUBANK, TAYLOR STOECKERT (APRN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:STOECKERT
Last Name:EUBANK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 AYSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-1450
Mailing Address - Country:US
Mailing Address - Phone:321-276-3401
Mailing Address - Fax:
Practice Address - Street 1:1763 AYSHIRE DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-1450
Practice Address - Country:US
Practice Address - Phone:321-276-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily