Healthcare Provider Details

I. General information

NPI: 1700727948
Provider Name (Legal Business Name): CARRIE MAST TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CORNING RD
CARY NC
27518-9229
US

IV. Provider business mailing address

213 CUSTER TRL
CARY NC
27513-4748
US

V. Phone/Fax

Practice location:
  • Phone: 919-694-7678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3866
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: