Provider Demographics
NPI:1508913278
Name:TAYLOR, SHEILA LYNETTE (MED)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:LYNETTE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:TAYLOR
Other - Last Name:GILLIAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 ASPEN ROAD
Mailing Address - Street 2:
Mailing Address - City:NICHOLLS
Mailing Address - State:GA
Mailing Address - Zip Code:31554
Mailing Address - Country:US
Mailing Address - Phone:678-813-7209
Mailing Address - Fax:
Practice Address - Street 1:117 ASPEN ROAD
Practice Address - Street 2:
Practice Address - City:NICHOLLS
Practice Address - State:GA
Practice Address - Zip Code:31554
Practice Address - Country:US
Practice Address - Phone:678-813-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor