Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APN0000007153 | TN |
N | 363L00000X | Nurse Practitioner | RN104363 | TN |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 7153 | TN |
NPI | 1003800616 |
---|---|
Provider Name | Phyllis Ann Taylor |
First Address | Mcminnville, TN 37111-0640 |
Second Address | Dresden, TN 38225-2308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 18/01/2019 |