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General NPI Number Information
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NPI Number | 1598251779
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Entity Type | Individual
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Provider Name | JESSICA JOY NOGGLE TAYLOR PHD, APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 3720 DAVINCI CT STE 400
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City | NORCROSS
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State | GA
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Zip | 30092-7625
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Country | US
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Telephone | 404-539-2481
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 DAVINCI CT STE 400
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City | NORCROSS
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State | GA
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Zip | 30092-7625
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Country | US
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Telephone |
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN252512
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License Number State | GA
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