Provider Demographics
NPI:1912430448
Name:TAYLOR, ALEXIS (ND)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3452 BELMONT HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-8924
Mailing Address - Country:US
Mailing Address - Phone:470-252-0172
Mailing Address - Fax:
Practice Address - Street 1:3452 BELMONT HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-8924
Practice Address - Country:US
Practice Address - Phone:470-252-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 175F00000X
GU172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No172V00000XOther Service ProvidersCommunity Health Worker