Provider Demographics
NPI:1194580431
Name:SPENCER, TAYLOR THOMPSON (AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:THOMPSON
Last Name:SPENCER
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7374
Mailing Address - Country:US
Mailing Address - Phone:336-889-8446
Mailing Address - Fax:
Practice Address - Street 1:1801 WESTCHESTER DRIVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-1457
Practice Address - Country:US
Practice Address - Phone:336-889-8446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020135363LA2200X, 363LG0600X
NC269207163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse