MEDICARE: JANICE R TAYLOR NP

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	363LG0600X	Gerontology Nurse Practitioner	5007492	NC
2	208M00000X	Hospitalist Physician	5007492	NC
3	163W00000X	Registered Nurse	137526	NC
4	363L00000X	Nurse Practitioner	5007492	NC
5	363LA2200X	Adult Health Nurse Practitioner	5007492	NC

General Provider Information

NPI Number	:	1285027938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE R TAYLOR NP

Provider Business Mailing Address
First Line	:	PO BOX 744786
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-4786
Country	:	US
Telephone Number	:	704-834-2450
Fax Number	:	704-671-5331

Provider Business Practice Location Address
First Line	:	1212 SPRUCE ST STE 305B
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-3386
Country	:	US
Telephone Number	:	704-865-1700
Fax Number	:	704-865-7948

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

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	07/20/2021

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