Provider Demographics
NPI:1871344218
Name:BOONE, TAYLOR (FNP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BOONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:CROSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:990 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2820
Mailing Address - Country:US
Mailing Address - Phone:505-977-7299
Mailing Address - Fax:
Practice Address - Street 1:990 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2820
Practice Address - Country:US
Practice Address - Phone:505-977-7299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily