Individual
JENNIFER R. TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 313, ABINGDON, VA 24211-7664
(276) 258-3780
(276) 258-3776
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0024166234
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487620274
—
VA
01
—
231160700
DOL
VA
01
—
P01214685
RR MEDICARE
—
05
—
Q004987
—
TN
Enumeration date
02/23/2006
Last updated
12/15/2023
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