Provider Demographics
NPI:1023797594
Name:TAYLOR, SUSAN MARIE (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MARIE
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:148 APACHE DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-9200
Mailing Address - Country:US
Mailing Address - Phone:843-708-0694
Mailing Address - Fax:
Practice Address - Street 1:3227 WALTER DR STE 1B
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-8171
Practice Address - Country:US
Practice Address - Phone:843-872-5454
Practice Address - Fax:843-872-5501
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.27525.APRN363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health