Provider Demographics
NPI:1831432186
Name:TAYLOR, AUDREY (R N)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3030
Mailing Address - Country:US
Mailing Address - Phone:404-612-1496
Mailing Address - Fax:404-335-5240
Practice Address - Street 1:99 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3030
Practice Address - Country:US
Practice Address - Phone:404-612-1496
Practice Address - Fax:404-995-5240
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN130496163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care