Provider Demographics
NPI:1861056608
Name:TAYLOR, TEMPERANCE (APRN)
Entity type:Individual
Prefix:
First Name:TEMPERANCE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 SMITHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-2576
Mailing Address - Country:US
Mailing Address - Phone:401-305-0080
Mailing Address - Fax:888-655-0696
Practice Address - Street 1:460 SMITHFIELD AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-2576
Practice Address - Country:US
Practice Address - Phone:401-305-0080
Practice Address - Fax:888-655-0696
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPAN1828363LF0000X
RIAPRN021192083B0002X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1164040069Medicaid