Provider Demographics
NPI:1801385976
Name:KELAMIS, TAYLOR BEAUREGARD (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:BEAUREGARD
Last Name:KELAMIS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MS
Other - First Name:TAYLOR
Other - Middle Name:GALE
Other - Last Name:BEAUREGARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 S THOMPSON ST STE 213
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-6941
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5100 S THOMPSON ST STE 213
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-6941
Practice Address - Country:US
Practice Address - Phone:479-275-3520
Practice Address - Fax:479-335-3405
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily