Provider Demographics
NPI:1013668912
Name:TAYLOR, LAUREN (DC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 LAUDERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-2817
Mailing Address - Country:US
Mailing Address - Phone:859-358-5086
Mailing Address - Fax:
Practice Address - Street 1:1740 N GERMANTOWN PKWY STE 6
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-3308
Practice Address - Country:US
Practice Address - Phone:901-752-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3537OtherSTATE OF TN DEPT. OF HEALTH