MEDICARE: TAYLOR DARDEN CNP

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	908223	MS

General Provider Information

NPI Number	:	1366398398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR DARDEN CNP

Provider Business Mailing Address
First Line	:	14615 LILLIAN WAY
Second Line	:
City	:	VANCLEAVE
State	:	MS
Zip	:	39565-4513
Country	:	US
Telephone Number	:	228-217-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1278 OCEAN SPRINGS RD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-3409
Country	:	US
Telephone Number	:	228-875-3606
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/11/2026

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