MEDICARE: TAYLOR BARNES WAYBURN

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	103TS0200X	School Psychologist	1292337	NC

General Provider Information

NPI Number	:	1437005048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR BARNES WAYBURN

Provider Business Mailing Address
First Line	:	2626 RAY RD
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-9206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2626 RAY RD
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-9206
Country	:	US
Telephone Number	:	910-436-3545
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ TAYLOR BARNES WAYBURN ” Practice Location

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