Provider Demographics
NPI:1174987432
Name:TAYLOR, NICOLE A (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-1519
Mailing Address - Country:US
Mailing Address - Phone:518-334-1538
Mailing Address - Fax:
Practice Address - Street 1:10 MCKOWN RD STE 102
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3473
Practice Address - Country:US
Practice Address - Phone:518-689-0244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY491467163W00000X
NYF405061-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse