Individual provider Active NPI

Taylor Nicole Mutchler

  • Pharmacist
  • Prince Frederick, MD
National Provider Identifier
1740811371
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28781 Issued in MD
Practice address
355 Market Square Dr
Prince Frederick, MD 20678-3173
Phone
(410) 535-5313
NPI assigned
Feb 2, 2020
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28781 MD Primary
Pharmacy Technician 183700000X PI02082 MD

Addresses

Primary practice location

355 Market Square Dr
Prince Frederick, MD 20678-3173

Mailing address

570 Carla Dr
Huntingtown, MD 20639-9648
Phone (301) 536-6451

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28781MDMDPharmacist
PI02082MDMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1580601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1740811371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 CARLA DR",
            "city": "HUNTINGTOWN",
            "state": "MD",
            "postal_code": "206399648",
            "telephone_number": "301-536-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 MARKET SQUARE DR",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783173",
            "telephone_number": "410-535-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCHLER",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-02",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "28781",
            "primary": true
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MD",
            "license": "PI02082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.