Provider Demographics
NPI:1750689105
Name:TAYLOR, HEATHER H (NP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:H
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4565 RALEIGH LAGRANGE DR
Mailing Address - Street 2:
Mailing Address - City:PIPERTON
Mailing Address - State:TN
Mailing Address - Zip Code:38017-4427
Mailing Address - Country:US
Mailing Address - Phone:901-468-5288
Mailing Address - Fax:
Practice Address - Street 1:4565 RALEIGH LAGRANGE DR
Practice Address - Street 2:
Practice Address - City:PIPERTON
Practice Address - State:TN
Practice Address - Zip Code:38017-4427
Practice Address - Country:US
Practice Address - Phone:256-571-6917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily