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Individual
MR. STACY LEE TAYLOR
Active
Individual
MR. STACY LEE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2011021213
MO
163WG0000X
General Practice Registered Nurse
2011021213
MO
163WM0705X
Medical-Surgical Registered Nurse
2011021213
MO
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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