Provider Demographics
NPI:1962840470
Name:WARREN-TAYLOR, MARY (NP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:WARREN-TAYLOR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 HOUMA BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4326
Mailing Address - Country:US
Mailing Address - Phone:504-779-2667
Mailing Address - Fax:504-889-7120
Practice Address - Street 1:3601 HOUMA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4326
Practice Address - Country:US
Practice Address - Phone:504-779-2667
Practice Address - Fax:504-889-7120
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARNO45301APO2846363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner