Provider Demographics
NPI:1215512991
Name:TAYLOR, ALEXANDER (RDN)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4943 W C ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4392
Mailing Address - Country:US
Mailing Address - Phone:970-779-2592
Mailing Address - Fax:
Practice Address - Street 1:4943 W C ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4392
Practice Address - Country:US
Practice Address - Phone:970-779-2592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered