Healthcare Provider Details

I. General information

NPI: 1063225241
Provider Name (Legal Business Name): MICHAEL EVERETT TAYLOR MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14725 DAUPHIN ISLAND PKWY
CODEN AL
36523-2927
US

IV. Provider business mailing address

14725 DAUPHIN ISLAND PKWY
CODEN AL
36523-2927
US

V. Phone/Fax

Practice location:
  • Phone: 251-465-0292
  • Fax:
Mailing address:
  • Phone: 251-458-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1-098300
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: