Provider Demographics
NPI:1215609219
Name:PINNEY, TAYLOR (CPNP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:PINNEY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 THACKERY ST APT 8204
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-3943
Mailing Address - Country:US
Mailing Address - Phone:318-230-5244
Mailing Address - Fax:
Practice Address - Street 1:6435 S FM 549 STE 201
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-6225
Practice Address - Country:US
Practice Address - Phone:214-771-3712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021149363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics