Provider Demographics
NPI:1174916761
Name:TAYLOR, MARCIA (PMHNP)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 GRAND AVE STE 129 PMB 484500
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2776
Mailing Address - Country:US
Mailing Address - Phone:406-690-1019
Mailing Address - Fax:
Practice Address - Street 1:1620 ALDERSON AVE UNIT 23
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4168
Practice Address - Country:US
Practice Address - Phone:406-690-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100374363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health