Doctor Name: | MS. LONNA LEE TAYLOR |
NPI Number: | 1184658098 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS RN APNP |
License Number: | 965033 |
Business Practice Address: | 121 W Main St Port Washington, WI - 530741813 |
Business Phone Number: | 2622848200 |
Business Fax Number: | 2622848104 |
Mailing Address: | 121 W Main St, PORT WASTHINGTON |
State: | WI |
Postal Code: | 530740994 |
Phone Number: | 2622848200 |
Fax Number: | 2622848104 |
NPI Enumeration Date: | 07/10/2006 |
NPI Last Update Date: | 05/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 965033 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |