Provider Demographics
NPI:1346719606
Name:MARCY, TAYLER DENISE
Entity Type:Individual
Prefix:
First Name:TAYLER
Middle Name:DENISE
Last Name:MARCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 FOUR SEASONS DR
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2434
Mailing Address - Country:US
Mailing Address - Phone:580-380-3228
Mailing Address - Fax:
Practice Address - Street 1:2008 FOUR SEASONS DR
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2434
Practice Address - Country:US
Practice Address - Phone:580-380-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator