Provider Demographics
NPI:1790192391
Name:TAYLOR, SARA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 842
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:TX
Mailing Address - Zip Code:75831-0842
Mailing Address - Country:US
Mailing Address - Phone:903-388-6772
Mailing Address - Fax:903-875-0351
Practice Address - Street 1:223 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5243
Practice Address - Country:US
Practice Address - Phone:903-388-6772
Practice Address - Fax:903-875-0351
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX758120163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management