Healthcare Provider Details

I. General information

NPI: 1205855277
Provider Name (Legal Business Name): STEPHANIE NICHOLAS TAYLOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/08/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 BOLIVAR ST
NEW ORLEANS LA
70112-1349
US

IV. Provider business mailing address

10724 BIG SUR DR
BATON ROUGE LA
70818-3103
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-5031
  • Fax: 504-568-8825
Mailing address:
  • Phone: 225-261-5901
  • Fax: 225-261-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number019963
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: