Provider Demographics
NPI:1407211543
Name:TAYLOR, BRANDEN DONELL (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:BRANDEN
Middle Name:DONELL
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 E EAGER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1196
Mailing Address - Country:US
Mailing Address - Phone:410-837-5676
Mailing Address - Fax:
Practice Address - Street 1:905 BAYARD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-3515
Practice Address - Country:US
Practice Address - Phone:410-837-5676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR195330363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health