Healthcare Provider Details

I. General information

NPI: 1396717609
Provider Name (Legal Business Name): PAMELA J. TAYLOR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 REGENT BLVD, SUITE 400 EMSI
IRVING TX
75063
US

IV. Provider business mailing address

343 RETRAC RD
LEXINGTON KY
40503-4379
US

V. Phone/Fax

Practice location:
  • Phone: 866-522-6596
  • Fax:
Mailing address:
  • Phone: 859-494-1249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5006642
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3003397
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: