Provider Demographics
NPI:1326380304
Name:TAYLOR, VERNON EUGENE JR (APRN)
Entity Type:Individual
Prefix:MR
First Name:VERNON
Middle Name:EUGENE
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:APRN
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Mailing Address - Street 1:368 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-9031
Mailing Address - Country:US
Mailing Address - Phone:606-215-0204
Mailing Address - Fax:606-523-8771
Practice Address - Street 1:39 CUMBERLAND GAP PLZ
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:KY
Practice Address - Zip Code:40734-4536
Practice Address - Country:US
Practice Address - Phone:606-526-9005
Practice Address - Fax:606-526-8607
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2019-01-17
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Provider Licenses
StateLicense IDTaxonomies
KY3007913363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100241410Medicaid