Provider Demographics
NPI:1538547690
Name:TAYLOR, HELEN DOROTHY (AGACNP)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:DOROTHY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18226 LURA LN
Mailing Address - Street 2:
Mailing Address - City:JONESTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78645-3427
Mailing Address - Country:US
Mailing Address - Phone:512-762-7932
Mailing Address - Fax:651-400-6676
Practice Address - Street 1:1600 W 38TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6405
Practice Address - Country:US
Practice Address - Phone:512-324-3549
Practice Address - Fax:512-342-3541
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08589363LG0600X
TXAP128010363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2408658Medicaid
MS2408658Medicaid
LA468481YH3UMedicare PIN