Provider Demographics
NPI:1154912913
Name:TAYLOR, MARK ALLEN JR (NP)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ALLEN
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 DICKERSON PIKE STE 680
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2537
Mailing Address - Country:US
Mailing Address - Phone:615-865-3322
Mailing Address - Fax:615-467-6692
Practice Address - Street 1:3443 DICKERSON PIKE STE 190
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2533
Practice Address - Country:US
Practice Address - Phone:615-301-8269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28902363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily