Provider Demographics
NPI:1225228919
Name:TAYLOR, MARK MAJOR (RN)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:MAJOR
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-4536
Mailing Address - Country:US
Mailing Address - Phone:803-479-5955
Mailing Address - Fax:
Practice Address - Street 1:18 ROSE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-4536
Practice Address - Country:US
Practice Address - Phone:803-479-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-28
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC79429163W00000X
CA631050163W00000X
MA257660163W00000X
NH052499-21163W00000X
GARN166152163W00000X
AZRN129654163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse