Healthcare Provider Details

I. General information

NPI: 1780184366
Provider Name (Legal Business Name): ANNE E TAYLOR AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 02/10/2024
Certification Date: 02/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 W DOYLE ST
TOCCOA GA
30577-1791
US

IV. Provider business mailing address

1295 HOPKINS LN
CLAYTON GA
30525-2405
US

V. Phone/Fax

Practice location:
  • Phone: 706-886-4673
  • Fax: 706-381-3100
Mailing address:
  • Phone: 404-786-8720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN135284
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: