Provider Demographics
NPI:1699320911
Name:TAYLOR, YALESHIA DIANN (NP-C)
Entity type:Individual
Prefix:
First Name:YALESHIA
Middle Name:DIANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 CAHABA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5225
Mailing Address - Country:US
Mailing Address - Phone:205-421-2079
Mailing Address - Fax:205-421-2109
Practice Address - Street 1:2807 GREYSTONE COMMERCIAL BLVD STE 38
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-9601
Practice Address - Country:US
Practice Address - Phone:205-995-1009
Practice Address - Fax:205-995-1049
Is Sole Proprietor?:No
Enumeration Date:2019-08-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF07191449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1699320911OtherN/A
1699320911OtherN/A