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Individual

TAYLOR NUGENT I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC,

Contact information

Practice address
3009 NEW BERN AVE, RALEIGH, NC 27610-1214
(919) 232-5020
Mailing address
3009 NEW BERN AVE, RALEIGH, NC 27610-1214
(919) 232-5020

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
ATH.200462
LA
2255A2300X
Athletic Trainer
Primary
LAT4484
NC

Other

Enumeration date
12/08/2015
Last updated
09/14/2022
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