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NPI Code Detail

MEDICARE: MRS. MIRANDI TAYLOR

MEDICARE: MRS. MIRANDI TAYLOR
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
1363L00000XNurse PractitionerNP289537GA

General Provider Information

NPI Number : 1477419646
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MIRANDI TAYLOR
Provider Business Mailing Address
First Line : 10 CYPRESS HILL CIR
Second Line :
City : HAZLEHURST
State : GA
Zip : 31539-8204
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1101 OCILLA RD
Second Line :
City : DOUGLAS
State : GA
Zip : 31533-2262
Country : US
Telephone Number : 912-384-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2025
Last Update Date : 12/31/2025

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Directions to “ MRS. MIRANDI TAYLOR ” Practice Location

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