Provider Demographics
NPI:1114587482
Name:TAYLOR, CHRISTOPHER GLENN (DNP-FNP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GLENN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3137 S TETON DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2330
Mailing Address - Country:US
Mailing Address - Phone:801-949-8883
Mailing Address - Fax:
Practice Address - Street 1:3137 S TETON DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-2330
Practice Address - Country:US
Practice Address - Phone:801-949-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9423301-3102163WN0800X
UT9423301-4409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience