Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | APRN11000577 | FL |
NPI | 1023582921 |
---|---|
Provider Name | Beth Ann Taylor |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Sarasota, FL 34236-6908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2019 |
Last Update Date | 15/01/2019 |