Provider Demographics
NPI:1235352600
Name:TAYLOR, AMY ELIZABETH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:955 RIBAUT RD
Mailing Address - Street 2:BMAC CREDENTIALING
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5441
Mailing Address - Country:US
Mailing Address - Phone:843-522-7843
Mailing Address - Fax:843-522-5678
Practice Address - Street 1:BEAUFORT MEMORIAL EXPRESS CARE & OCCUPATIONAL HEALTH
Practice Address - Street 2:974 RIBAUT RD
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5486
Practice Address - Country:US
Practice Address - Phone:843-524-3344
Practice Address - Fax:844-295-9894
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2019-12-26
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Provider Licenses
StateLicense IDTaxonomies
MDR084245363LP0200X
SC3393363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD221407500Medicaid
SCNP5411Medicaid