Provider Demographics
NPI:1902602246
Name:TAYLOR, KARYN LYNN (RD, MS, LD)
Entity type:Individual
Prefix:
First Name:KARYN
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:
Credentials:RD, MS, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4054 EGRET PERCH CT
Mailing Address - Street 2:
Mailing Address - City:RAVENEL
Mailing Address - State:SC
Mailing Address - Zip Code:29470-3326
Mailing Address - Country:US
Mailing Address - Phone:843-714-0182
Mailing Address - Fax:
Practice Address - Street 1:4054 EGRET PERCH CT
Practice Address - Street 2:
Practice Address - City:RAVENEL
Practice Address - State:SC
Practice Address - Zip Code:29470-3326
Practice Address - Country:US
Practice Address - Phone:843-714-0182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC379133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered