Provider Demographics
NPI:1619619178
Name:TAYLOR, LENORA BRI'ONNA (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:LENORA
Middle Name:BRI'ONNA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 GRAND AVE APT B
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6070
Mailing Address - Country:US
Mailing Address - Phone:325-513-8584
Mailing Address - Fax:
Practice Address - Street 1:2110 N WILLIS ST STE B
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-4352
Practice Address - Country:US
Practice Address - Phone:325-232-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074766363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology