Provider Demographics
NPI:1639732332
Name:TAYLOR, ABIGAIL TRUELY (AG-ACNP)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:TRUELY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:MISS
Other - First Name:ABIGAIL
Other - Middle Name:TRUELY
Other - Last Name:MCMANIGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:8295 COUNTY ROAD 4029
Mailing Address - Street 2:
Mailing Address - City:KEMP
Mailing Address - State:TX
Mailing Address - Zip Code:75143-3550
Mailing Address - Country:US
Mailing Address - Phone:765-585-2411
Mailing Address - Fax:
Practice Address - Street 1:8295 COUNTY ROAD 4029
Practice Address - Street 2:
Practice Address - City:KEMP
Practice Address - State:TX
Practice Address - Zip Code:75143-3550
Practice Address - Country:US
Practice Address - Phone:765-585-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144155363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner