Provider Demographics
NPI:1023530565
Name:TAYLOR, TERRY L (PMHNP-BC, FNP-BC)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S FERN ST # 98484
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-2810
Mailing Address - Country:US
Mailing Address - Phone:804-531-4732
Mailing Address - Fax:804-999-0385
Practice Address - Street 1:1806 SUMMIT AVE STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4339
Practice Address - Country:US
Practice Address - Phone:804-531-4732
Practice Address - Fax:804-964-3159
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-15
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175106363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily