Healthcare Provider Details

I. General information

NPI: 1346043122
Provider Name (Legal Business Name): TAYLOR KAITLYN MEDLIN PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 SKYLAND DR
SYLVA NC
28779-8002
US

IV. Provider business mailing address

1188 SKYLAND DR
SYLVA NC
28779-8002
US

V. Phone/Fax

Practice location:
  • Phone: 828-339-2273
  • Fax:
Mailing address:
  • Phone: 828-339-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5021899
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: