Individual
GARY LEE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 ILLINOIS AVE, STEVENS POINT, WI 54481-3114
(715) 346-5000
Mailing address
900 ILLINOIS AVE, STEVENS POINT, WI 54481-3114
(715) 346-5000
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
132736-030
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
3375
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132736-30
RN WI STATE LICENSE
WI
01
—
3375
WI STATE LICENSE
WI
Enumeration date
04/19/2006
Last updated
06/07/2012
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