Healthcare Provider Details

I. General information

NPI: 1356869598
Provider Name (Legal Business Name): BRITTANY CLAYTON TAYLOR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY RENEE CLAYTON FNP-C

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 ALCORN DR STE 109
CORINTH MS
38834
US

IV. Provider business mailing address

401 ALCORN DR STE 2C
CORINTH MS
38834-9073
US

V. Phone/Fax

Practice location:
  • Phone: 662-286-1499
  • Fax: 662-293-9401
Mailing address:
  • Phone: 662-293-7266
  • Fax: 662-293-6255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number902279
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: