Provider Demographics
NPI:1588851430
Name:ROYSTON, DELLA TAYLOR (WOMENS HEALTH NP)
Entity Type:Individual
Prefix:MRS
First Name:DELLA
Middle Name:TAYLOR
Last Name:ROYSTON
Suffix:
Gender:F
Credentials:WOMENS HEALTH NP
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Mailing Address - Street 1:135 HENRY PARKWAY
Mailing Address - Street 2:HENRY CO HEALTH DEPT
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253
Mailing Address - Country:US
Mailing Address - Phone:770-954-2250
Mailing Address - Fax:770-954-2269
Practice Address - Street 1:135 HENRY PARKWAY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253
Practice Address - Country:US
Practice Address - Phone:770-954-2250
Practice Address - Fax:770-954-2269
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN030096NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health