Provider Demographics
NPI:1497145478
Name:NUTINI, TAYLOR MARIE
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:MARIE
Last Name:NUTINI
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 1:3040 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3176
Mailing Address - Country:US
Mailing Address - Phone:252-355-6450
Mailing Address - Fax:
Practice Address - Street 1:3040 EVANS ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3176
Practice Address - Country:US
Practice Address - Phone:252-355-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37266183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician