Provider Demographics
NPI:1861858102
Name:GWENDOLYN FLOWERS-TAYLOR
Entity Type:Organization
Organization Name:GWENDOLYN FLOWERS-TAYLOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FLOWERS-TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-377-8539
Mailing Address - Street 1:134 SPALDING ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-3836
Mailing Address - Country:US
Mailing Address - Phone:770-377-8539
Mailing Address - Fax:
Practice Address - Street 1:134 SPALDING ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-3836
Practice Address - Country:US
Practice Address - Phone:770-377-8539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN193250163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty