Individual
TAYLOR MARIE MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11115 PARKVIEW PLAZA DRIVE, APT, SUITE, FLOOR, ETC., FORT WAYNE, IN 46845
(260) 672-6400
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
28241412A
IN
363L00000X
Nurse Practitioner
Primary
71012991A
IN
Other
Enumeration date
07/11/2022
Last updated
03/24/2023
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