Taylor Blades, RN,BSN

Individual provider Active NPI School Registered Nurse · Farmington, NM

NPI 1649080102 · NPPES record last updated Jan 8, 2025

Key facts

NPI
1649080102
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
69121 (NM)
Practice address
3401 E 30TH St
Farmington, NM 87402-8805
Phone
(505) 599-8617
Fax
(855) 290-2205
NPI assigned
Jan 8, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
69121NMMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 69121 NM Yes

Addresses

Primary practice location

3401 E 30TH St
Farmington, NM 87402-8805

Mailing address

3401 E 30TH St
Farmington, NM 87402-8805

Other providers in Farmington, NM

All providers in Farmington, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.