Provider Demographics
NPI:1720016363
Name:TAYLOR, DONYA RACHELLE (CRNA)
Entity Type:Individual
Prefix:
First Name:DONYA
Middle Name:RACHELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 UNIVERSITY BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2029
Mailing Address - Country:US
Mailing Address - Phone:205-759-7352
Mailing Address - Fax:205-759-6397
Practice Address - Street 1:809 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2029
Practice Address - Country:US
Practice Address - Phone:205-759-7352
Practice Address - Fax:205-759-6397
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-075380163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL071252OtherAMERICAN ASSOCIATION OF NURSE ANESTHETISTS (CERTIFICATION)
AL071252OtherAMERICAN ASSOCIATION OF NURSE ANESTHETISTS (CERTIFICATION)
AL51519847Medicare ID - Type UnspecifiedC.R.N.A.