Basic Information
| Provider Information | |||||||||
| NPI: | 1407211543 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | BRANDEN | ||||||||
| MiddleName: | DONELL | ||||||||
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| Credential: | CRNP-PMH | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22259 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212034259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108375676 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1407 YORK RD SUITE 310 | ||||||||
| Address2: | LAFFERMAN AND ASSOCIATES | ||||||||
| City: | LUTHERVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108252281 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2015 | ||||||||
| LastUpdateDate: | 12/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | R195330 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.