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General NPI Number Information
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NPI Number | 1891504783
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Entity Type | Individual
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Provider Name | TAYLOR RENEA SPARKS APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 130 DANIEL DR
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City | DANVILLE
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State | KY
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Zip | 40422-2527
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Country | US
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Telephone | 859-236-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 199 ROSS RD
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City | LANCASTER
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State | KY
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Zip | 40444-9728
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Country | US
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Telephone | 859-339-4802
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4033627
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License Number State | KY
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