TAYLOR WALLACE (NPI# 1104472760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104472760 |
| Entity Type | Individual |
| Full Name | TAYLOR WALLACE |
| Practice Address |
2791 S 2475 E Salt Lake Cty UT 84109-1825 |
| Practice Telephone | 8016316285 |
| Mailing Telephone | 8016316285 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174133052 | Taylor K Wallace | Nurse's Aide | 13525 Bartram Park Blvd Unit 1538, Jacksonville, FL 32258-5271 | 2020-08-05 |
| 1659921229 | Taylor Ann Wallace | Occupational Therapy Assistant | 4257 Rufe Snow Dr Apt 622, North Richland Hills, TX 76180-8572 | 2019-09-16 |
| 1689186728 | Taylor Kiana Wallace | Speech-Language Pathologist | 101 Uhland Rd, San Marcos, TX 78666-6630 | 2017-10-30 |
| 1982028270 | Taylor Wallace | Chiropractor | 430 South Elm Street, Bald Knob, AR 72010-1177 | 2014-02-07 |
| Street Address |
2791 S 2475 E |
| City | SALT LAKE CTY |
| State | UT |
| Zip Code | 84109-1825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102095 | Aimee Hadfield | Social Worker | Hearten House, 314 W. Broadway #222, Salt Lake City, UT 84109 | 2020-07-23 |
| 1245877448 | Carla Lucile Applegate-anderson | Nurse Practitioner | 2666 South 2000 East, Suite 101, Salt Lake City, UT 84109 | 2019-12-06 |
| 1063991982 | Madison Sanderson | Physical Therapist | 2295 S Foothill Dr Ste 1, Salt Lake City, UT 84109 | 2018-08-10 |
| 1023545951 | Tyler Dale Hanks | Dentist | 2435 E 3300 S, Suite 101, Millcreek, UT 84109 | 2017-05-23 |
| 1992198881 | Cynthia R Thorpe | Marriage & Family Therapist | 2624 East Mount Crest Drive, Salt Lake City, UT 84109 | 2015-03-17 |
| 1104247295 | John Paul Lapine | Dentist | 3865 South 3500 East Ste. 201, Salt Lake City, UT 84109 | 2013-12-17 |
| 1073850301 | Weston J Horne | Massage Therapist | 2760 South 1174 East, Suite 1d, Salt Lake City, UT 84109 | 2013-01-07 |
| 1538415138 | Dominic Falsone | Counselor | 3846 Villa Dr, Salt Lake City, UT 84109 | 2012-08-01 |
| 1487926341 | Richard R Flynn | Pediatrics | 2342 Dallin St., Salt Lake City, UT 84109 | 2012-02-07 |
| 1235449984 | Keyhan Koohgivi | Pharmacist | 2566 East Sage Way, Salt Lake City, UT 84109 | 2010-10-15 |
| Find all providers in zip 84109 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951683 | Nichole Brenner | Technician | 5694 S Sarah Jane Dr, Kearns, UT 84118-7549 | 2020-10-27 |
| 1447877097 | Brianna Bravo | Technician | 13510 S Wasatch Point Ln Apt 31207, Draper, UT 84020-8045 | 2020-06-30 |
| 1235766692 | Zarella Alban | Technician | 1857 S 400 E, Bountiful, UT 84010-5432 | 2020-03-25 |
| 1649804964 | Marci Sorrels | Technician | 329 E 8680 S, Sandy, UT 84070-1645 | 2020-02-25 |
| 1669022356 | Taffy Kosierowski | Technician | 1036 E 7625 S, Midvale, UT 84047-2957 | 2019-09-16 |
| 1619527397 | Judy Wheelwright | Technician | 1370 Henderson Dr, Ogden, UT 84404-6555 | 2019-09-16 |
| 1073160073 | Charlene Paul | Technician | 1857 W 800 N, Salt Lake City, UT 84116-1860 | 2019-08-23 |
| 1831745462 | Karen Thomas | Technician | 983 E 300 S, Kaysville, UT 84037-2207 | 2019-08-09 |
| 1538714126 | Becky Mccrory | Technician | 9543 S Echo Ridge Dr, West Jordan, UT 84081-4206 | 2019-08-09 |
| 1043865884 | Tina Severson | Technician | 8330 S 2200 W, West Jordan, UT 84088-9514 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CTY |
| Zip Code | 84109 |
Please comment or provide details below to improve the information on TAYLOR WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.