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General NPI Number Information
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NPI Number | 1407211543
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Entity Type | Individual
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Provider Name | BRANDEN DONELL TAYLOR CRNP-PMH
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Gender | Male
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 905 BAYARD ST
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City | BALTIMORE
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State | MD
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Zip | 21223-3515
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Country | US
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Telephone | 410-837-5676
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 E EAGER ST
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City | BALTIMORE
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State | MD
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Zip | 21205-1196
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Country | US
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Telephone | 410-837-5676
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R195330
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License Number State | MD
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