Healthcare Provider Details

I. General information

NPI: 1770195216
Provider Name (Legal Business Name): RACHEL OLIVIA TAYLOR MCLEOD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 E PRITCHARD ST
ASHEBORO NC
27203-4807
US

IV. Provider business mailing address

9841 NORTHLAKE CENTRE PKWY
CHARLOTTE NC
28216-8930
US

V. Phone/Fax

Practice location:
  • Phone: 336-963-3093
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024180023
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5013827
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5013827
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001267964
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: