Provider Demographics
NPI:1942925334
Name:DEAL, TAYLOR ANN (MSN, RN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:DEAL
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 S 169TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-9300
Mailing Address - Country:US
Mailing Address - Phone:402-941-7850
Mailing Address - Fax:402-815-9181
Practice Address - Street 1:2560 N HEALTHY WAY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2315
Practice Address - Country:US
Practice Address - Phone:402-941-7850
Practice Address - Fax:402-815-9181
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1671325163WP0808X
NE115436363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health