Provider Demographics
NPI:1194325894
Name:TAYLOR, AMY ELIZABETH
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2069 MILLSTONE RUN RD
Mailing Address - Street 2:
Mailing Address - City:NAPIER
Mailing Address - State:WV
Mailing Address - Zip Code:26631-7107
Mailing Address - Country:US
Mailing Address - Phone:304-644-6718
Mailing Address - Fax:
Practice Address - Street 1:369 SCOTTS FORK BONNIE ROAD
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601
Practice Address - Country:US
Practice Address - Phone:304-689-3006
Practice Address - Fax:304-689-3005
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV6237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist