MEDICARE: TAYLOR LINDSEY MCDONALD APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN88911	WV

General Provider Information

NPI Number	:	1083174031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR LINDSEY MCDONALD APRN, FNP-C

Provider Business Mailing Address
First Line	:	179 MCDONALD DR
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-1594
Country	:	US
Telephone Number	:	304-871-0251
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 CHENOWETH CREEK RD
Second Line	:
City	:	ELKINS
State	:	WV
Zip	:	26241-9237
Country	:	US
Telephone Number	:	304-637-5006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2019
Last Update Date	:	03/24/2019

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