Provider Demographics
NPI:1295136018
Name:TAYLOR, CHRISTA (CMA (AAMA))
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CMA (AAMA)
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:BEATY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN (ARDMS ELIGIBLE)
Mailing Address - Street 1:153 ALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37705-3910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:153 ALLEY RD
Practice Address - Street 2:
Practice Address - City:ANDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37705-3910
Practice Address - Country:US
Practice Address - Phone:865-603-1738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography