Individual
MRS. NICOLE DEWEESE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2300 MANCHESTER EXPY, STE B001, COLUMBUS, GA 31904-6808
(706) 324-4891
(706) 576-4958
Mailing address
PO BOX 9027, COLUMBUS, GA 31908-9027
(706) 324-4891
(706) 576-4958
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN176264
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136455B
—
GA
01
—
202I427010
MEDICARE PTAN
GA
01
—
RN176264
LICENSE
GA
Enumeration date
04/17/2013
Last updated
05/07/2015
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