Healthcare Provider Details

I. General information

NPI: 1871982421
Provider Name (Legal Business Name): BRIANNA DANIELLE TAYLOR RN/BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 MAPLE ST
GREENSBORO NC
27405-6910
US

IV. Provider business mailing address

466 BEDFORD PARK DR
WINSTON SALEM NC
27107-2006
US

V. Phone/Fax

Practice location:
  • Phone: 336-641-3000
  • Fax: 336-336-3740
Mailing address:
  • Phone: 336-456-5633
  • Fax: 336-366-3740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number266431
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: