Provider Demographics
NPI:1851951131
Name:TAYLOR, CYNTHIA RENEE (FNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:RENEE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 ROSS CARTER BLVD
Mailing Address - Street 2:
Mailing Address - City:DUFFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24244-5117
Mailing Address - Country:US
Mailing Address - Phone:276-690-7161
Mailing Address - Fax:276-690-7246
Practice Address - Street 1:198 ROSS CARTER BLVD
Practice Address - Street 2:
Practice Address - City:DUFFIELD
Practice Address - State:VA
Practice Address - Zip Code:24244-5117
Practice Address - Country:US
Practice Address - Phone:276-690-7161
Practice Address - Fax:276-690-7246
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001213961363LF0000X
VAF04190673207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily