Provider Demographics
NPI:1336162163
Name:TAYLOR, NANCY GALT (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:GALT
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4916 BRISTOW DR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5456
Mailing Address - Country:US
Mailing Address - Phone:434-422-0037
Mailing Address - Fax:888-398-9722
Practice Address - Street 1:4916 BRISTOW DR
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5456
Practice Address - Country:US
Practice Address - Phone:434-422-0037
Practice Address - Fax:888-398-9722
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556829111N00000X, 111NN1001X, 111NP0017X, 111NP0017X, 111N00000X
NC3202111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU58150Medicare UPIN