Provider Demographics
NPI:1477165215
Name:ATKINS, TAYLOR FERGUSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:FERGUSON
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31154 COLOSSE RD
Mailing Address - Street 2:
Mailing Address - City:CARRSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23315-3029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1017 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-0048
Practice Address - Country:US
Practice Address - Phone:757-335-4537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022188291835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist