Provider Demographics
NPI:1396717609
Name:TAYLOR, PAMELA J (ARNP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:J
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 RETRAC RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4379
Mailing Address - Country:US
Mailing Address - Phone:859-494-1249
Mailing Address - Fax:
Practice Address - Street 1:3050 REGENT BLVD, SUITE 400
Practice Address - Street 2:EMSI
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:866-522-6596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006642363LF0000X
KY3003397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily