Individual
JODIE MARIE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3034
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 873-9533
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
37756
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430031020
RAILROAD-MEDICARE
NC
05
—
8050136
—
NC
Enumeration date
01/26/2007
Last updated
12/29/2014
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