Healthcare Provider Details

I. General information

NPI: 1124125794
Provider Name (Legal Business Name): SHARON LOUISE TAYLOR ARNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 WATSON BLVD
WARNER ROBINS GA
31093-3606
US

IV. Provider business mailing address

125 BUNKERS TRL
WARNER ROBINS GA
31088-7513
US

V. Phone/Fax

Practice location:
  • Phone: 478-929-8030
  • Fax:
Mailing address:
  • Phone: 478-929-1055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN151696
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: