Healthcare Provider Details

I. General information

NPI: 1831522192
Provider Name (Legal Business Name): KIMBERLY WALKER TAYLOR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 N LINDSAY ST
HIGH POINT NC
27262-4303
US

IV. Provider business mailing address

PO BOX 249
YADKINVILLE NC
27055-0249
US

V. Phone/Fax

Practice location:
  • Phone: 336-883-0029
  • Fax: 336-883-0867
Mailing address:
  • Phone: 336-679-4963
  • Fax: 336-679-2549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5006354
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: