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Individual

TAYLOR MICHAEL MUDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1795
(270) 745-1000
Mailing address
1563 POSEY HILL RD, MOUNT JULIET, TN 37122-6033
(615) 351-0185

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
183514
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
3012665
KY

Other

Enumeration date
08/20/2018
Last updated
09/09/2018
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