Provider Demographics
NPI:1518204288
Name:TAYLOR, JENNIFER (NNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:TAYLOR
Other - Last Name:GIUDICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP-BC
Mailing Address - Street 1:341 DANBY WOODS CT
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-6014
Mailing Address - Country:US
Mailing Address - Phone:303-620-6243
Mailing Address - Fax:
Practice Address - Street 1:295 MIDLAND PKWY
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8104
Practice Address - Country:US
Practice Address - Phone:843-970-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24206363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60333570Medicaid