Provider Demographics
NPI:1285027938
Name:TAYLOR, JANICE R (NP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:R
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 744786
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-4786
Mailing Address - Country:US
Mailing Address - Phone:704-834-2450
Mailing Address - Fax:704-671-5331
Practice Address - Street 1:1212 SPRUCE ST STE 305B
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3386
Practice Address - Country:US
Practice Address - Phone:704-865-1700
Practice Address - Fax:704-865-7948
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5007492363LG0600X, 208M00000X, 363L00000X, 363LA2200X
NC137526163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner