=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417822305
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAYLOR MICHELLE HOLLAND DNP, APRN, CPNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2025
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 414 GRAND PARK DR STE 1
-----------------------------------------------------
City | PARKERSBURG
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26105-4065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-599-8000
-----------------------------------------------------
Fax | 304-599-8003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 231 MORGAN DR
-----------------------------------------------------
City | SANDYVILLE
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25275-6680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-532-6344
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 124401
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 124401
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------