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

Taylor John Park, FNP

Individual provider Family Nurse Practitioner · NPI 1629743612

Taylor John Park, FNP is a Nurse Practitioner in Saint Peters, Missouri. Qualified in 2014, 12 years ago. Practices with Midwest ENT Centre, PC, a 12-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
12
Licensed in
MO
In the registry since
2021
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone: (636) 441-3100
Fax: (636) 441-8072
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2021009812 (MO)

Record details

NPI number1629743612
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 11, 2021
Last updated in NPPESJuly 21, 2022
Certification dateJuly 21, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Midwest Ent Centre, Pc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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