Individual provider · Type 1 NPI

Angenette Shane Taylor, CNP

Gerontology Nurse Practitioner · Dallas, TX

NPI number 1760081871 Active

Practice location

4055 Valley View Ln Ste 700
Dallas, TX 75244-5045

Mailing address

4055 Valley View Ln Ste 400
Dallas, TX 75244-5071

Other practice locations

  • 1000 Medical Center Blvd, Lawrenceville, GA 30046-7694 · (678) 312-3294

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X4704250947 (MI)
Acute Care Nurse Practitioner 363LA2100X4704250947 (MI)
Gerontology Nurse Practitioner 363LG0600XRN156114 (GA)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1760081871

Angenette Shane Taylor, CNP's National Provider Identifier is 1760081871, issued on Oct 20, 2020. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Dallas, TX. The record was last updated on Oct 17, 2024.