Provider Demographics
NPI:1346757010
Name:TAYLOR, TAURA (MED)
Entity Type:Individual
Prefix:
First Name:TAURA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 KIRBY PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3666
Mailing Address - Country:US
Mailing Address - Phone:901-265-7077
Mailing Address - Fax:
Practice Address - Street 1:9442 AFTON GROVE RD
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7520
Practice Address - Country:US
Practice Address - Phone:901-265-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 171M00000X, 1744P3200X, 174H00000X, 253Z00000X, 332U00000X, 343900000X, 347C00000X, 373H00000X, 385H00000X, 225C00000X
TN132700000X, 320800000X, 3747A0650X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
No174H00000XOther Service ProvidersHealth Educator
No253Z00000XAgenciesIn Home Supportive Care
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care