Provider Demographics
NPI:1619678760
Name:TAYLOR, DEBRA MICHELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:MICHELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ESTILL SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37330-3819
Mailing Address - Country:US
Mailing Address - Phone:931-636-1905
Mailing Address - Fax:
Practice Address - Street 1:266 JOYCE LN
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2568
Practice Address - Country:US
Practice Address - Phone:931-967-3826
Practice Address - Fax:931-962-1168
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000098793164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse