Taylor, Autumn Nicole
Taylor, Autumn Nicole is an sole proprietor health care provider with primary practice located at 1750 S 4Th St , Champaign IL 61820-6948. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Taylor, Autumn Nicole can be contacted via phone (443) 883-0156.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X |
Profile Details
| NPI number | 1346759586 |
|---|---|
| LBN Legal business name | Taylor, Autumn Nicole |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2017 |
| Last updated | Oct 30th, 2020 - about 6 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 | 1346759586 | NPPES |
| Illinois | Other | 096.005126 | IDFPR- ATHLETIC TRAINER LICENSE |
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