Provider Demographics
NPI:1124817309
Name:TAYLOR, REBECCA LYNN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 LONA JOHN RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:AL
Mailing Address - Zip Code:35550-4138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 MEDICAL CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3428
Practice Address - Country:US
Practice Address - Phone:205-384-0141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2025019998363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health