Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN038362 | GA |
NPI | 1083864276 |
---|---|
Provider Name | Warene K Taylor |
First Address | Columbus, GA 31908-8147 |
Second Address | Columbus, GA 31904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2008 |
Last Update Date | 30/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
157405376B | (05) | GA |