Provider Demographics
NPI:1124805403
Name:TAYLOR, TAYLOR CELESTE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:CELESTE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:TAYLOR
Other - Middle Name:CELESTE
Other - Last Name:SODERBORG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7671 S 3800 W
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-4316
Mailing Address - Country:US
Mailing Address - Phone:801-282-4766
Mailing Address - Fax:801-282-4772
Practice Address - Street 1:7671 S 3800 W
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-4316
Practice Address - Country:US
Practice Address - Phone:801-282-4766
Practice Address - Fax:801-282-4772
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10716210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist