Provider Demographics
NPI:1245968361
Name:TAYLOR, SHARON YVONNE (LDO)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:YVONNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALMART VISION CENTER
Mailing Address - Street 2:1024 NORTH MAIN ST.
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356
Mailing Address - Country:US
Mailing Address - Phone:859-885-2314
Mailing Address - Fax:859-885-5130
Practice Address - Street 1:WALMART VISION CENTER
Practice Address - Street 2:1024 NORTH MAIN ST.
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356
Practice Address - Country:US
Practice Address - Phone:859-885-2314
Practice Address - Fax:859-885-5130
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY110638156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician