Provider Demographics
NPI:1790851137
Name:HARDEN TAYLOR, ANNETTE MARIE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:MARIE
Last Name:HARDEN TAYLOR
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:HARDEN TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:99 JESSE HILL JR DRIVE SE
Mailing Address - Street 2:ROOM 402
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-730-1217
Mailing Address - Fax:
Practice Address - Street 1:1920 JOHN WESLEY
Practice Address - Street 2:COLLEGE PARK REGIONAL HEALTH CENTER
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337
Practice Address - Country:US
Practice Address - Phone:404-730-1217
Practice Address - Fax:404-765-4149
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN093396163W00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse