Mould, Taylor
Mould, Taylor is an individual health care provider with primary practice located at 11850 Blackfoot St Nw Ste 490 , Coon Rapids MN 55433-2773. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Mould, Taylor can be contacted via phone (763) 427-1137.Contact Information
Primary practice address
11850 Blackfoot St Nw Ste 490
Coon Rapids MN 55433-2773
Phone: (763) 427-1137
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 14370 | Minnesota |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 14370 | Minnesota |
Profile Details
| NPI number | 1245938489 |
|---|---|
| LBN Legal business name | Mould, Taylor |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 17th, 2023 |
| Last updated | Apr 12th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245938489 | NPPES |
| Minnesota | Other | 1200585 | NCCPA |
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11850 Blackfoot St Nw Ste 490 , Coon Rapids MN 55433-2773