Provider Demographics
NPI:1114566858
Name:TAYLOR, REBEKAH (CRNP)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 AL HIGHWAY 157
Mailing Address - Street 2:STE 302
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-1273
Mailing Address - Country:US
Mailing Address - Phone:256-736-6224
Mailing Address - Fax:
Practice Address - Street 1:1800 AL HIGHWAY 157 STE 302
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-1273
Practice Address - Country:US
Practice Address - Phone:256-736-6224
Practice Address - Fax:256-736-6226
Is Sole Proprietor?:No
Enumeration Date:2019-12-28
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1137207363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily