Provider Demographics
NPI:1548025802
Name:GREY-TAYLOR, TONYA R
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:R
Last Name:GREY-TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 AMETHYST CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-8454
Mailing Address - Country:US
Mailing Address - Phone:706-409-3206
Mailing Address - Fax:
Practice Address - Street 1:220 AMETHYST CT
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-8454
Practice Address - Country:US
Practice Address - Phone:706-409-3206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide