Healthcare Provider Details

I. General information

NPI: 1396413258
Provider Name (Legal Business Name): TAYLAR S MCMILLIAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7715 AVERIETT DR
MONTGOMERY AL
36116-8865
US

IV. Provider business mailing address

7715 AVERIETT DR
MONTGOMERY AL
36116-8865
US

V. Phone/Fax

Practice location:
  • Phone: 334-232-0355
  • Fax: 334-234-8837
Mailing address:
  • Phone: 334-232-0355
  • Fax: 334-234-8837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-164435
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-164435
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-164435
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-164435
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-164435
License Number StateAL
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-164435
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: