Healthcare Provider Details

I. General information

NPI: 1770541658
Provider Name (Legal Business Name): JANICE MARIE ALEXANDER TAYLOR CNM, MN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANICE ALEXANDER-TAYLOR CNM, MN

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 WESVILL CT SUITE 210
RALEIGH NC
27607-2973
US

IV. Provider business mailing address

2304 WESVILL CT SUITE 210
RALEIGH NC
27607-2973
US

V. Phone/Fax

Practice location:
  • Phone: 919-782-6700
  • Fax: 919-782-2218
Mailing address:
  • Phone: 919-782-6700
  • Fax: 919-782-2218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberCNM044 ACNM4360
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: