Provider Demographics
NPI:1659847879
Name:KINGSBURY-TAYLOR, ARTINA (RN)
Entity Type:Individual
Prefix:MRS
First Name:ARTINA
Middle Name:
Last Name:KINGSBURY-TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 HOWE LN
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2453
Mailing Address - Country:US
Mailing Address - Phone:470-354-9600
Mailing Address - Fax:
Practice Address - Street 1:148 HOWE LN
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2453
Practice Address - Country:US
Practice Address - Phone:470-354-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN26134163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health