MEDICARE: TAYLER MAULDIN

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	363LF0000X	Family Nurse Practitioner	RN271830	GA

General Provider Information

NPI Number	:	1477014603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLER MAULDIN

Provider Business Mailing Address
First Line	:	3030 HEATHERWYN WAY
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-7865
Country	:	US
Telephone Number	:	770-910-0355
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 PROMINENCE CT
Second Line	:
City	:	DAWSONVILLE
State	:	GA
Zip	:	30534-6372
Country	:	US
Telephone Number	:	770-532-7202
Fax Number	:

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

Provider Enumeration Date	:	03/29/2019
Last Update Date	:	10/15/2025

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Directions to “ TAYLER MAULDIN ” Practice Location

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