=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922811306
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAYLOR ANN DREW, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2025
-----------------------------------------------------
Last Update Date | 01/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1018 THOMASVILLE RD STE 104
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32303-6271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-270-7227
-----------------------------------------------------
Fax | 850-738-5830
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1700 N MONROE ST STE 11-111
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32303-5535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-270-7227
-----------------------------------------------------
Fax | 850-738-5830
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TAYLOR ANN DREW
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 850-270-7227
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------