Provider Demographics
NPI:1275243925
Name:TAYLOR, ANDREA (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N WESTOVER BLVD.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707
Mailing Address - Country:US
Mailing Address - Phone:229-405-6249
Mailing Address - Fax:229-329-4373
Practice Address - Street 1:235 WALNUT ST.
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763
Practice Address - Country:US
Practice Address - Phone:229-759-6508
Practice Address - Fax:229-329-4373
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN233248163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse