Healthcare Provider Details

I. General information

NPI: 1730894817
Provider Name (Legal Business Name): MONICA TAYLOR APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 DOWELL RD
RUSSELL SPRINGS KY
42642-4278
US

IV. Provider business mailing address

1949 GOLDSMITH LN STE 103
LOUISVILLE KY
40218-3096
US

V. Phone/Fax

Practice location:
  • Phone: 270-866-2440
  • Fax: 270-866-2440
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3018934
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: