Provider Demographics
NPI:1700527330
Name:TAYLOR, EDDIE RAY (NP)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:RAY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2201 S STERLING ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4044
Mailing Address - Country:US
Mailing Address - Phone:828-580-6753
Mailing Address - Fax:828-580-6759
Practice Address - Street 1:2201 S STERLING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4044
Practice Address - Country:US
Practice Address - Phone:828-580-6753
Practice Address - Fax:828-580-6759
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC280064363L00000X
NC5016488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner