Provider Demographics
NPI:1861228066
Name:TAYLOR, KAITLYN E (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:E
Other - Last Name:INGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8003 CASTLEWAY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1946
Mailing Address - Country:US
Mailing Address - Phone:317-576-1335
Mailing Address - Fax:317-343-6562
Practice Address - Street 1:120 SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2304
Practice Address - Country:US
Practice Address - Phone:812-405-1857
Practice Address - Fax:912-954-5022
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71015785A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily