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Individual

BENJAMIN M. TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
520 S EAGLE RD, SUITE 2204, MERIDIAN, ID 83642-6351
(208) 381-6196
(208) 381-6199
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1115A
ID

Other

Enumeration date
10/10/2011
Last updated
09/15/2012
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