Provider Demographics
NPI:1255010914
Name:TAYLOR, AMBER LYNN
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:TAYLOR
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 1:515 HARBOR POINT RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:TN
Mailing Address - Zip Code:37640-7530
Mailing Address - Country:US
Mailing Address - Phone:404-394-8474
Mailing Address - Fax:
Practice Address - Street 1:515 HARBOR POINT RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:TN
Practice Address - Zip Code:37640-7530
Practice Address - Country:US
Practice Address - Phone:404-394-8474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
TN6222363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant