Tina M Taylor, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP30006904 Issued in WA

Practice address

945 11TH Ave Ste B
Longview, WA 98632-2555

Phone

(360) 414-8600

Fax

(360) 636-7372

NPI assigned

Sep 26, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Tina M Hudson Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Northwest Psychological Resources LLCGroup PAC ID 0244122745, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northwest Psychological Resources LLC

  • Clinical Neuropsychologist
  • Longview, WA
  • NPI 1811079049
  Medicare reassignment Care Compare group NPD
• Cowlitz Indian Tribe

  • Public Health & General Preventive Medicine Physician
  • Longview, WA
  • NPI 1619194123
  NPD (past)
• Cowlitz Indian Tribe

  • General Practice Physician
  • Longview, WA
  • NPI 1851328447
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1306832274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486",
            "telephone_number": "360-575-8275",
            "fax_number": "360-575-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 11TH AVE STE B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322555",
            "telephone_number": "360-414-8600",
            "fax_number": "360-636-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "RN00113328",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30006904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9643701",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8901809",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "HUDSON",
            "middle_name": "M",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Lynn Taylor, M. ED
• Jessica Lea Taylor, HOME CARE AIDE
• Mackenzie L Taylor, LICSW
• Michelle Taylor, BA, AAC
• Samantha Taylor
• Brittney Morghan Teaney
• Suzanne Tear, MA
• Crystal Tencheira
• Teresa H Connors DDS, PS
• Prakash Thapaliya, M,D.

• Psychiatric/Mental Health Nurse Practitioner in Longview, WA
• Providers in Longview, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.