Provider Demographics
NPI:1285686808
Name:TAYLOR, KRISTA L (FNP)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2967 DAVISON CT
Mailing Address - Street 2:STE A
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-3285
Mailing Address - Country:US
Mailing Address - Phone:530-458-8050
Mailing Address - Fax:530-458-2044
Practice Address - Street 1:173 E WEBSTER ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2949
Practice Address - Country:US
Practice Address - Phone:530-458-8050
Practice Address - Fax:530-458-5936
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA466184363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP64210Medicare UPIN
CAZZZ23880ZMedicare ID - Type Unspecified