Provider Demographics
NPI:1417952599
Name:TAYLOR, RACHEL W (APRN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:W
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 MILITARY TRL STE 101A
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5700
Mailing Address - Country:US
Mailing Address - Phone:561-459-8955
Mailing Address - Fax:
Practice Address - Street 1:875 MILITARY TRL STE 101A
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5700
Practice Address - Country:US
Practice Address - Phone:561-459-8955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9443470363LW0102X
KY3004324363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000339752OtherBLUE CROSS/BLUE SHIELD
KY78013075Medicaid
KY50005704OtherPASSPORT
KYQ22814Medicare UPIN
KY1267822Medicare ID - Type UnspecifiedMEDICARE