=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699320911
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YALESHIA DIANN TAYLOR NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2019
-----------------------------------------------------
Last Update Date | 10/04/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2807 GREYSTONE COMMERCIAL BLVD STE 38
-----------------------------------------------------
City | HOOVER
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-9601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-995-1009
-----------------------------------------------------
Fax | 205-995-1049
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3700 CAHABA BEACH RD
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-5225
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-421-2079
-----------------------------------------------------
Fax | 205-421-2109
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F07191449
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------