Healthcare Provider Details

I. General information

NPI: 1891750204
Provider Name (Legal Business Name): BEVERLY ANN TAYLOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 01/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 JOEL DR BLANCHFIELD ARMY COMMUNITY HOSPITAL
FT CAMPBELL KY
42223-5349
US

IV. Provider business mailing address

1701 E 9TH ST
HOPKINSVILLE KY
42240-4431
US

V. Phone/Fax

Practice location:
  • Phone: 270-956-0521
  • Fax: 270-798-8501
Mailing address:
  • Phone: 270-886-9053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1080349
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: