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General NPI Number Information
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NPI Number | 1457404287
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Entity Type | Individual
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Provider Name | JESSICA L TAYLOR NP
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 10620 SPOTSYLVANIA AVE
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-2637
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Country | US
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Telephone | 540-710-1086
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Fax |
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Provider Business Mailing Address
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Address Line | 385 GARRISONVILLE RD STE 205
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City | STAFFORD
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State | VA
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Zip | 22554-1599
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Country | US
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Telephone | 540-710-1086
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024173708
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN134886
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License Number State | AZ
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