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General NPI Number Information
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NPI Number | 1972166064
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Entity Type | Individual
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Provider Name | TAYLER KRISTINA MAYO MSN, AGPNP- C, APRN
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 10/18/2020
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Provider Practice Location Address
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Address Line | 1670 CLAIRMONT RD
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City | DECATUR
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State | GA
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Zip | 30033-4004
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Country | US
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Telephone | 404-321-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 2996 NAPPA TRL
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-4141
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Country | US
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Telephone | 678-332-1099
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 259836
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 259836
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 259836
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License Number State | GA
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