Healthcare Provider Details

I. General information

NPI: 1881626794
Provider Name (Legal Business Name): CLAUDIA ANN TAYLOR R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD
DECATUR GA
30033-4004
US

IV. Provider business mailing address

125 NEWBERRY ST
FAYETTEVILLE GA
30215-5479
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax: 404-329-4622
Mailing address:
  • Phone: 404-321-6111
  • Fax: 404-329-4622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN028369
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: