Basic Information
| Provider Information | |||||||||
| NPI: | 1710127782 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | |||||||||
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| Credential: | R.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17280 HIGHWAY 17 | ||||||||
| Address2: | P O BOX 479 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390956614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6628341857 | ||||||||
| FaxNumber: | 6628341859 | ||||||||
| Practice Location | |||||||||
| Address1: | 17280 HIGHWAY 17 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390956614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6628341857 | ||||||||
| FaxNumber: | 6628341859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2009 | ||||||||
| LastUpdateDate: | 03/03/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | D1178 | MS | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.