Individual
MISS MICHELLE VAUGHN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C. F. N. P.
Contact information
Practice address
971 LAKELAND DR STE 1250, JACKSON, MS 39216-4609
(601) 200-2990
(601) 200-5939
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R870165
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02907245
—
MS
Enumeration date
11/15/2006
Last updated
02/26/2019
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