Provider Demographics
NPI:1215255567
Name:TAYLOR, WENDY E (CDE,RN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CDE,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-5701
Mailing Address - Fax:840-777-7320
Practice Address - Street 1:901 E CHEVES ST
Practice Address - Street 2:SUITE 420
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2716
Practice Address - Country:US
Practice Address - Phone:843-777-5701
Practice Address - Fax:843-777-7320
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23029163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator