Provider Demographics
NPI:1548275456
Name:TAYLOR-ALI, CAROL YVETTE (RN)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:YVETTE
Last Name:TAYLOR-ALI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 CHRISTIANA XING
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7007
Mailing Address - Country:US
Mailing Address - Phone:770-963-6519
Mailing Address - Fax:
Practice Address - Street 1:1970 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5937
Practice Address - Country:US
Practice Address - Phone:404-417-1734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN119828163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse