Healthcare Provider Details

I. General information

NPI: 1023530565
Provider Name (Legal Business Name): TERRY L TAYLOR PMHNP-BC, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2017
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 S 12TH ST STE 307
RICHMOND VA
23219-4282
US

IV. Provider business mailing address

500 WESTOVER DR PMB 33307
SANFORD NC
27330-8941
US

V. Phone/Fax

Practice location:
  • Phone: 804-531-4732
  • Fax: 804-999-0385
Mailing address:
  • Phone: 804-531-4732
  • Fax: 804-999-0385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024175106
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024175106
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: