MEDICARE: LISA MICHELLE TAYLOR-JOHNSON

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	172A00000X	Driver

General Provider Information

NPI Number	:	1952260887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MICHELLE TAYLOR-JOHNSON

Provider Business Mailing Address
First Line	:	551 S MANGUM ST SUITE 100
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701
Country	:	US
Telephone Number	:	919-429-7307
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 S. MANGUM ST SUITE 100
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701
Country	:	US
Telephone Number	:	919-429-7307
Fax Number	:

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “ LISA MICHELLE TAYLOR-JOHNSON ” Practice Location

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