Healthcare Provider Details

I. General information

NPI: 1053132506
Provider Name (Legal Business Name): YOLANDA M TAYLOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1284 PERRY HILL RD STE G
MONTGOMERY AL
36109-5225
US

IV. Provider business mailing address

1284 PERRY HILL RD STE G
MONTGOMERY AL
36109-5225
US

V. Phone/Fax

Practice location:
  • Phone: 334-782-1595
  • Fax:
Mailing address:
  • Phone: 334-782-1595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number1-184313
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: