Individual
ANGENETTE SHANE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4055 VALLEY VIEW LN STE 700, DALLAS, TX 75244-5045
(972) 715-3800
Mailing address
4055 VALLEY VIEW LN STE 400, DALLAS, TX 75244-5071
(972) 715-3800
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
4704250947
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704250947
MI
363LG0600X
Gerontology Nurse Practitioner
RN156114
GA
Other
Enumeration date
10/20/2020
Last updated
10/17/2024
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