Provider Demographics
NPI:1831839430
Name:PERRY, TAYLOR (APRN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIRACLE STRIP LOOP
Mailing Address - Street 2:UNIT 6
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32407-8410
Mailing Address - Country:US
Mailing Address - Phone:850-238-8811
Mailing Address - Fax:850-238-8868
Practice Address - Street 1:5 MIRACLE STRIP LOOP STE 6
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32407-8410
Practice Address - Country:US
Practice Address - Phone:850-238-8811
Practice Address - Fax:850-238-8868
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11018957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily