Provider Demographics
NPI:1083174031
Name:MCDONALD, TAYLOR LINDSEY (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LINDSEY
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 MCDONALD DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1594
Mailing Address - Country:US
Mailing Address - Phone:304-871-0251
Mailing Address - Fax:
Practice Address - Street 1:55 CHENOWETH CREEK RD
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-9237
Practice Address - Country:US
Practice Address - Phone:304-637-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-24
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN88911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily