Provider Demographics
NPI:1598251779
Name:NOGGLE TAYLOR, JESSICA JOY (PHD, APRN, NP-C)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:JOY
Last Name:NOGGLE TAYLOR
Suffix:
Gender:F
Credentials:PHD, APRN, NP-C
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Other - Middle Name:
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Mailing Address - Street 1:3720 DAVINCI CT STE 400
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-7625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3720 DAVINCI CT STE 400
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-7625
Practice Address - Country:US
Practice Address - Phone:404-539-2481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN252512363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology