Healthcare Provider Details

I. General information

NPI: 1750483475
Provider Name (Legal Business Name): DANICA S TAYLOR CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3058 MOBILE HWY
MONTGOMERY AL
36108-4027
US

IV. Provider business mailing address

1225 MEDICAL CENTER PKWY
SELMA AL
36701-6797
US

V. Phone/Fax

Practice location:
  • Phone: 334-420-5001
  • Fax: 334-420-0160
Mailing address:
  • Phone: 334-872-9410
  • Fax: 334-872-9411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1-089844
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: