Audrea Lacey Landers Taylor, APRN, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

30492 Issued in TN

Practice address

401 Wilson Ave
Tullahoma, TN 37388-3357

Phone

(931) 580-2787

NPI assigned

Sep 19, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1598488249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HAMPSHIRE RD",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371609503",
            "telephone_number": "931-580-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 WILSON AVE",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883357",
            "telephone_number": "931-580-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "AUDREA",
        "middle_name": "LACEY LANDERS",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "30492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Systems Integration Modeling & Simulation, Inc.
• Ken T Takegami, MD
• Jennifer Tallman, NP-C
• Charles Alan Tate
• Jaunita Southard Tate
• Barbara Jan Taylor, PHARMD
• Ian S Taylor, MD
• Janet Lynn Taylor
• Philicia Ann Taylor, CRNA
• Anita Ann Teal

• Nurse Practitioner in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.