Provider Demographics
NPI:1245861046
Name:BUCHANAN, TAFFY L
Entity type:Individual
Prefix:
First Name:TAFFY
Middle Name:L
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S LYNDON ST STE 16
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2926
Mailing Address - Country:US
Mailing Address - Phone:347-619-3816
Mailing Address - Fax:
Practice Address - Street 1:205 S LYNDON ST STE 16
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2926
Practice Address - Country:US
Practice Address - Phone:347-619-3816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCE7173132700000X, 133NN1002X, 2471C3402X
NC1845173000000X
NC7267933202K00000X, 246RP1900X
NCNH28451744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No173000000XOther Service ProvidersLegal Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography