Provider Demographics
NPI:1528865680
Name:BILLINGSLEY, TAYLOR ALYSSE (NP)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALYSSE
Last Name:BILLINGSLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ALYSSE
Other - Last Name:SHARITS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:229 JOHN LOVELACE RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30241-9523
Mailing Address - Country:US
Mailing Address - Phone:702-624-8769
Mailing Address - Fax:
Practice Address - Street 1:229 JOHN LOVELACE RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-9523
Practice Address - Country:US
Practice Address - Phone:702-624-8769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN300383363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner