Healthcare Provider Details

I. General information

NPI: 1770475824
Provider Name (Legal Business Name): TAYLOR CANNON JAMES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BAPTIST DR STE 401
MADISON MS
39110-2012
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 601-973-1517
  • Fax: 601-973-1623
Mailing address:
  • Phone: 901-226-4003
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number907513
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: