Provider Demographics
NPI:1962862524
Name:TAYLOR, STEPHANIE DELANE (CSFA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DELANE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 WESTBURY CT SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-1823
Mailing Address - Country:US
Mailing Address - Phone:256-221-0122
Mailing Address - Fax:
Practice Address - Street 1:204 LOWE AVE SE
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4262
Practice Address - Country:US
Practice Address - Phone:256-517-8861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant