MEDICARE: TAYLA CLAY APRN

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	906716	MS

General Provider Information

NPI Number	:	1184438756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLA CLAY APRN

Provider Business Mailing Address
First Line	:	PO BOX 497
Second Line	:
City	:	AUGUSTA
State	:	AR
Zip	:	72006-0497
Country	:	US
Telephone Number	:	870-347-2534
Fax Number	:

Provider Business Practice Location Address
First Line	:	7474 HIGHWAY 45 ALT N
Second Line	:
City	:	WEST POINT
State	:	MS
Zip	:	39773-7981
Country	:	US
Telephone Number	:	662-575-0057
Fax Number	:

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

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	05/28/2026

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