MEDICARE: TAYLOR TODD

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	0001296568	VA

General Provider Information

NPI Number	:	1295679991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR TODD

Provider Business Mailing Address
First Line	:	10336 HAMPSHIRE GREEN AVE
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-3218
Country	:	US
Telephone Number	:	540-209-2668
Fax Number	:

Provider Business Practice Location Address
First Line	:	10336 HAMPSHIRE GREEN AVE
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22032-3218
Country	:	US
Telephone Number	:	540-209-2668
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ TAYLOR TODD ” Practice Location

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