Healthcare Provider Details

I. General information

NPI: 1821918590
Provider Name (Legal Business Name): DANIELLE NICOLE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 N ARTIZAN ST
WILLIAMSPORT MD
21795-1104
US

IV. Provider business mailing address

39 BELGIAN RUN
MARTINSBURG WV
25404-1164
US

V. Phone/Fax

Practice location:
  • Phone: 301-223-7971
  • Fax:
Mailing address:
  • Phone: 304-616-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number119102
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: