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General NPI Number Information
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NPI Number | 1093079477
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Entity Type | Individual
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Provider Name | ALEXIS TAYLOR FREDERICK MSN, CEN, ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 80 JESSIE HILL JR DRIVE SE GRADY MEMORIAL HOSPITAL
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City | ATLANTA
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State | GA
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Zip | 30303
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Country | US
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Telephone | 404-752-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 2920 BROOKEVALE CT
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City | ALPHARETTA
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State | GA
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Zip | 30004-8466
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Country | US
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Telephone | 850-445-5640
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN178750
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License Number State | GA
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