Provider Demographics
NPI:1376886655
Name:TAYLOR, BRYNN JENNY LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYNN
Middle Name:JENNY LOUISE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRYNN
Other - Middle Name:JENNY LOUISE TAYLOR
Other - Last Name:SMEDRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1302 ROCKY POINT DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5864
Mailing Address - Country:US
Mailing Address - Phone:541-789-2541
Mailing Address - Fax:
Practice Address - Street 1:700 SW RAMSEY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5786
Practice Address - Country:US
Practice Address - Phone:541-507-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD173709207Q00000X
CAA154041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine