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General NPI Number Information
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NPI Number | 1679787972
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Entity Type | Individual
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Provider Name | JARROD WAYNE TAYLOR CRNP
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Gender | Male
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 28730 AL HIGHWAY 99 SUITE D
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City | ELKMONT
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State | AL
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Zip | 35620-7951
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Country | US
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Telephone | 256-232-1400
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Fax | 256-232-1425
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Provider Business Mailing Address
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Address Line | PO BOX 1044
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City | ATHENS
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State | AL
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Zip | 35612-1044
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Country | US
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Telephone | 256-232-1400
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Fax | 256-232-1425
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F0206076
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License Number State | AL
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