Provider Demographics
NPI:1487287116
Name:TAYLOR, TEON (APRN)
Entity type:Individual
Prefix:
First Name:TEON
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 ALDER BROOK WAY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-9078
Mailing Address - Country:US
Mailing Address - Phone:954-696-3672
Mailing Address - Fax:
Practice Address - Street 1:2033 BUFORD HWY STE 109
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8802
Practice Address - Country:US
Practice Address - Phone:954-696-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANCO-000001363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care