Provider Demographics
NPI:1144927013
Name:TRIPP, TAYLOR NOELLE (PMHNP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NOELLE
Last Name:TRIPP
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W CADBURY DR APT H306
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5809
Mailing Address - Country:US
Mailing Address - Phone:720-435-3686
Mailing Address - Fax:
Practice Address - Street 1:420 W CADBURY DR APT H306
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5809
Practice Address - Country:US
Practice Address - Phone:720-435-3686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11128597-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health