Provider Demographics
NPI:1710243548
Name:TAYLOR, MEAGHAN S (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MEAGHAN
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 SOUTHRIDE LN
Mailing Address - Street 2:
Mailing Address - City:BONIFAY
Mailing Address - State:FL
Mailing Address - Zip Code:32425-3325
Mailing Address - Country:US
Mailing Address - Phone:850-547-4440
Mailing Address - Fax:850-547-4441
Practice Address - Street 1:3120 SOUTHRIDE LN
Practice Address - Street 2:
Practice Address - City:BONIFAY
Practice Address - State:FL
Practice Address - Zip Code:32425
Practice Address - Country:US
Practice Address - Phone:850-547-4440
Practice Address - Fax:850-547-4441
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9250876363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004762300Medicaid
FLFZ35ZMedicare PIN