Healthcare Provider Details

I. General information

NPI: 1235054032
Provider Name (Legal Business Name): CELENA KATE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 LAFAYETTE PKWY
LAGRANGE GA
30241-2566
US

IV. Provider business mailing address

1579 HINES RD
LAGRANGE GA
30241-7884
US

V. Phone/Fax

Practice location:
  • Phone: 706-530-2151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP304977
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: