Basic Information
| Provider Information | |||||||||
| NPI: | 1114566858 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | REBEKAH | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 AL HIGHWAY 157 | ||||||||
| Address2: | STE 302 | ||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350581273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567366224 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1800 AL HIGHWAY 157 STE 302 | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350581273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567366224 | ||||||||
| FaxNumber: | 2567366226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2019 | ||||||||
| LastUpdateDate: | 12/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1137207 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.