Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 1081016 | AL |
N | 363LC1500X | Nurse Practitioner - Community Health | 1081016 | AL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1081016 | AL |
N | 363LP2300X | Nurse Practitioner - Primary Care | 1081016 | AL |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 1081016 | AL |
NPI | 1164729406 |
---|---|
Provider Name | Ameshia D Bush Taylor |
First Address | Mobile, AL 36603-5478 |
Second Address | Mobile, AL 36603-5478 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2011 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1081016 | STATE LICENSE (01) | AL |