Healthcare Provider Details

I. General information

NPI: 1689645996
Provider Name (Legal Business Name): ANNE MARIE TAYLOR ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE MARIE DUVAL ANP

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 N. PARIS AVENUE
PORT ROYAL SC
29935-2029
US

IV. Provider business mailing address

1833 N. PARIS AVENUE
PORT ROYAL SC
29935-2029
US

V. Phone/Fax

Practice location:
  • Phone: 843-522-1420
  • Fax: 843-522-1460
Mailing address:
  • Phone: 843-522-1420
  • Fax: 843-522-1460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA2500
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: