Provider Demographics
NPI:1174242614
Name:HAVENSTEIN, TAYLOR LYNNE (MSN,APRN,FNP-BC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LYNNE
Last Name:HAVENSTEIN
Suffix:
Gender:F
Credentials:MSN,APRN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 RESEARCH PARK DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5000
Mailing Address - Country:US
Mailing Address - Phone:785-537-2651
Mailing Address - Fax:
Practice Address - Street 1:1325 RESEARCH PARK DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5000
Practice Address - Country:US
Practice Address - Phone:785-537-2651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS81490363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner