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General NPI Number Information
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NPI Number | 1508957499
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Entity Type | Individual
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Provider Name | MELISSA ANN TAYLOR CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2020 ALEXANDER DR
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City | DOTHAN
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State | AL
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Zip | 36301-3004
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Country | US
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Telephone | 334-673-4166
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Fax | 334-673-4170
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Provider Business Mailing Address
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Address Line | 104 BRECKENRIDGE LN
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City | DOTHAN
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State | AL
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Zip | 36303-9322
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Country | US
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Telephone | 334-792-5911
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1-084727
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License Number State | AL
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