Healthcare Provider Details

I. General information

NPI: 1518588987
Provider Name (Legal Business Name): TAYLOR ELIZABETH LUGASH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

185 TRIMBLE CREST DR
ATLANTA GA
30342-2488
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN290736
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: