Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Taylor

Individual provider Registered Nurse · NPI 1255876348

Ethan Taylor is a Certified Registered Nurse Anesthetist (CRNA) in Tyler, Texas. Qualified in 2016, 10 years ago. Practices with Northstar Anesthesia III PA, a 399-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Louisiana and Texas.

Years since qualifying
10
Licensed in
LA, TX
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

800 E Dawson St
Tyler, TX 75701-2036
Phone: (903) 606-4522
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2901 4th St, Longview, TX 75605-5128 — (903) 758-1818
  • 800 E Dawson St, Tyler, TX 75701-2036 — (903) 606-4522

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence AP132890 (TX)
Registered Nurse Taxonomy 163W00000X · Licence 853309 (TX)
Registered Nurse Taxonomy 163W00000X · Licence RN139391 (LA)

Record details

NPI number1255876348
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 27, 2016
Last updated in NPPESApril 30, 2021
Certification dateApril 30, 2021
Mailing addressPo Box 841656, Dallas, TX 75284-1656

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Northstar Anesthesia Iii Pa — 399 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Tyler