Provider Demographics
NPI:1194316745
Name:BOYLE, TAYLOR NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:NICOLE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 OGLETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2242
Mailing Address - Country:US
Mailing Address - Phone:706-549-6838
Mailing Address - Fax:
Practice Address - Street 1:795 OGLETHORPE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2242
Practice Address - Country:US
Practice Address - Phone:706-549-6838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist