TAYLOR NICOLE FIVEASH (NPI# 1962922427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962922427 |
| Entity Type | Individual |
| Full Name | TAYLOR NICOLE FIVEASH |
| Credential | FNP-C |
| Practice Address |
101 W Northisde Dr, Bldg G Valdosta GA 31602 |
| Practice Telephone | 9123840600 |
| Mailing Telephone | 9123840600 |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2019-01-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
230599 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1305 Ocilla Rd, Douglas, GA 315332209 | 9123840600 |
| Street Address |
101 W NORTHISDE DR, BLDG G |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| 1952701641 | Alan Vega | Military Health Care Provider | 3715 N Valdosta Rd Apt 82, Valdosta, GA 31602 | 2014-08-29 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356847743 | Timothy Blake Taylor | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-04-04 |
| 1609230069 | Kenneth Lindsey Kiser | Nurse Practitioner | 2209 Pineview Dr, Valdosta, GA 31602-7316 | 2016-04-11 |
| 1881023844 | Lori Gordon Tomlinson | Nurse Practitioner | 2301 N Ashley St, Valdosta, GA 31602-2620 | 2013-11-10 |
| 1144535840 | Keri L Amerson | Nurse Practitioner | 3321 N Valdosta Rd Ste B, Valdosta, GA 31602-1685 | 2010-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639784788 | Natasha Allen | Nurse Practitioner | 4177 Pelham Cir, Lithonia, GA 30038-6140 | 2020-09-14 |
| 1336753920 | Henny P Brown | Nurse Practitioner | 3430 Ridgeland Pl, Alpharetta, GA 30004-8483 | 2020-09-01 |
| 1487267415 | Alethea Hope Tucker | Nurse Practitioner | 3685 Braselton Hwy Ste 100, Dacula, GA 30019-5920 | 2020-08-28 |
| 1952913808 | Carol Jo Wilbanks | Nurse Practitioner | 206 Crest Dr, Rock Spring, GA 30739-2041 | 2020-08-21 |
| 1164032017 | Myiesha Sellers Mcfarlin | Nurse Practitioner | 55 Sellers Ln, Baxley, GA 31513-2208 | 2020-08-05 |
| 1124645395 | Kisha Smalley | Nurse Practitioner | 117 Gambier Cv, Mcdonough, GA 30252-6273 | 2020-07-02 |
| 1346861127 | Finan Tedla | Nurse Practitioner | 2626 Peachtree Rd Nw Unit 1802, Atlanta, GA 30305-5633 | 2020-05-03 |
| 1841819547 | Millicent Charte Duncan | Nurse Practitioner | 138 Parkview Rd, Savannah, GA 31419-9672 | 2020-04-13 |
| 1891329660 | Tracey Lynn Murray | Nurse Practitioner | 980 Johnson Ferry Rd Ste 880, Sandy Springs, GA 30342-1609 | 2020-03-02 |
| 1841820917 | Vedic Family Practice and Wellness | Nurse Practitioner | 1240 Upper Hembree Rd Ste E, Roswell, GA 30076-0914 | 2020-01-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.