Healthcare Provider Details

I. General information

NPI: 1215255567
Provider Name (Legal Business Name): WENDY E. TAYLOR CDE,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E CHEVES ST SUITE 420
FLORENCE SC
29506-2716
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-5701
  • Fax: 843-777-7320
Mailing address:
  • Phone: 843-777-5701
  • Fax: 840-777-7320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number23029
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: