Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 347629-4405 | UT |
N | 363L00000X | Nurse Practitioner | 53-75567-051 | KS |
NPI | 1013174317 |
---|---|
Provider Name | Miss Ligia J Taylor |
First Address | Fort Leavenworth, KS 66027-1126 |
Second Address | Fort Leavenworth, KS 66027-1126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2008 |
Last Update Date | 08/12/2015 |