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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 8 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245938489 NPPES
Minnesota Other 1200585 NCCPA

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