Healthcare Provider Details

I. General information

NPI: 1609607407
Provider Name (Legal Business Name): TAYLOR LINDSEY MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 UNION UNIVERSITY DR STE A
JACKSON TN
38305-3856
US

IV. Provider business mailing address

1270 UNION UNIVERSITY DR STE A
JACKSON TN
38305-3856
US

V. Phone/Fax

Practice location:
  • Phone: 731-664-0103
  • Fax:
Mailing address:
  • Phone: 731-664-0103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN0000035976
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: