Provider Demographics
NPI:1518597418
Name:TAYLOR, HOLLY BRIANNA (RN)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:BRIANNA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 N HABANA AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7124
Mailing Address - Country:US
Mailing Address - Phone:813-841-0767
Mailing Address - Fax:
Practice Address - Street 1:4714 N HABANA AVE APT 206
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7124
Practice Address - Country:US
Practice Address - Phone:813-841-0767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9494058163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty