Healthcare Provider Details

I. General information

NPI: 1134040801
Provider Name (Legal Business Name): CARA TAYLOR RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E SYCAMORE ST
HAZLEHURST GA
31539-6162
US

IV. Provider business mailing address

28 HILLTOP DR
LUMBER CITY GA
31549-2600
US

V. Phone/Fax

Practice location:
  • Phone: 912-699-0100
  • Fax:
Mailing address:
  • Phone: 229-315-1920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN149592
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: