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General NPI Number Information
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NPI Number | 1922674175
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Entity Type | Individual
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Provider Name | ALLYSON TAYLOR VON KANNEL CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 05/28/2021
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Last Update Date | 05/28/2021
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Provider Practice Location Address
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Address Line | 424 OLD CHEROKEE RD
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City | LEXINGTON
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State | SC
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Zip | 29072-6972
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Country | US
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Telephone | 800-352-0580
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Fax | 803-520-5801
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Provider Business Mailing Address
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Address Line | 2214 OLD CHEROKEE RD
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City | LEXINGTON
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State | SC
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Zip | 29072-9725
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Country | US
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Telephone | 803-520-9380
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Fax | 803-520-5972
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 24981
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License Number State | SC
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