Provider Demographics
NPI:1710329149
Name:TAYLOR, AMANDA GRACE OSWALD (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:GRACE OSWALD
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 N HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3310
Mailing Address - Country:US
Mailing Address - Phone:843-884-8281
Mailing Address - Fax:
Practice Address - Street 1:1676 N HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3310
Practice Address - Country:US
Practice Address - Phone:843-884-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily