Provider Demographics
NPI:1679759112
Name:TAYLOR, NANCY RAINWATER (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:RAINWATER
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CENTURY PLAZA DR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-0850
Mailing Address - Country:US
Mailing Address - Phone:864-888-2535
Mailing Address - Fax:
Practice Address - Street 1:100 CENTURY PLAZA DR
Practice Address - Street 2:SUITE 6A
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-0850
Practice Address - Country:US
Practice Address - Phone:864-888-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ340228382Medicare PIN