MEDICARE: TAYLOR E BREEDEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer		VA

General Provider Information

NPI Number	:	1427908946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR E BREEDEN

Provider Business Mailing Address
First Line	:	620 ELLIOT DR
Second Line	:
City	:	PURCELLVILLE
State	:	VA
Zip	:	20132-3389
Country	:	US
Telephone Number	:	703-261-3583
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 UNIVERSITY DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-4422
Country	:	US
Telephone Number	:	703-993-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ TAYLOR E BREEDEN ” Practice Location

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