Provider Demographics
NPI:1053650465
Name:TAYLOR, CONNIE LYNN (RN, BSN)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SPEARS CREEK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-9313
Mailing Address - Country:US
Mailing Address - Phone:803-699-2700
Mailing Address - Fax:803-699-2704
Practice Address - Street 1:500 SPEARS CREEK CHURCH RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-9313
Practice Address - Country:US
Practice Address - Phone:803-699-2700
Practice Address - Fax:803-699-2704
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN50592R163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool