Healthcare Provider Details

I. General information

NPI: 1699603282
Provider Name (Legal Business Name): TAYLORED HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N 2ND ST STE 100
RICHMOND KY
40475-1408
US

IV. Provider business mailing address

103 LURLINGTON CT
HOPKINSVILLE KY
42240-8755
US

V. Phone/Fax

Practice location:
  • Phone: 270-589-9644
  • Fax:
Mailing address:
  • Phone: 270-589-9644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LESLIE TAYLOR
Title or Position: OWNER, PRACTITIONER
Credential: DNP, APRN, FNP-BC
Phone: 270-589-9644