Provider Demographics
NPI:1114010816
Name:TAYLOR, CLAYTON (CRNA)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 KIMBERLY AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-2646
Mailing Address - Country:US
Mailing Address - Phone:770-861-6437
Mailing Address - Fax:
Practice Address - Street 1:191 BILTMORE AVENUE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4109
Practice Address - Country:US
Practice Address - Phone:828-254-0881
Practice Address - Fax:828-254-1614
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPENDING367500000X
NC4102367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered