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Individual

DUSTIN A. TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-3744
Mailing address
1000 E 24TH ST STE 2E, KANSAS CITY, MO 64108-2776
(816) 404-5850

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
53-76164-082
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2019038872
MO

Other

Enumeration date
11/16/2012
Last updated
06/22/2021
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