| Taylor Doktycz, | |
|
4691 Deveron Dr, Kernersville, NC 27284-6857 | |
| (860) 281-2252 | |
| (336) 203-2211 |
| Full Name | Taylor Doktycz |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 4691 Deveron Dr, Kernersville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497417257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 59.001659 (Connecticut) | Secondary |
| 133V00000X | Dietitian, Registered | L008072 (North Carolina) | Primary |
| Provider Name | Ilivewell Nutrition Therapy, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1093150070 PECOS PAC ID: 5496186009 Enrollment ID: O20200515000498 |
| Provider Name | Nourish, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
| Mailing Address | Practice Location Address |
|---|---|
| Taylor Doktycz, 4691 Deveron Dr, Kernersville, NC 27284-6857 Ph: (860) 281-2252 | Taylor Doktycz, 4691 Deveron Dr, Kernersville, NC 27284-6857 Ph: (860) 281-2252 |
Mrs. Mary Ellen Tuitt, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1710 Kernersville Medical Parkway, Suite 210, Kernersville, NC 27284 Phone: 336-718-6770 Fax: 336-277-1889 | |
Elizabeth Anne Weathers, RD, RDN, LDN Dietitian Medicare: Medicare Enrolled Practice Location: 1730 Kernersville Medical Pkwy, Kernersville, NC 27284 Phone: 336-564-4950 | |
Lauren Duquette, RDN, LDN Dietitian Medicare: Medicare Enrolled Practice Location: 500 Pineview Dr Ste 205, Kernersville, NC 27284 Phone: 336-329-3295 | |
Jason Scott Gray, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 500 Pineview Dr Ste 205, Kernersville, NC 27284 Phone: 336-329-3295 Fax: 336-355-5204 | |
Amanda Smith, RD, LDN, CHWC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1710 Kernersville Medical Pkwy, Suite 210, Kernersville, NC 27284 Phone: 336-564-4950 | |
Paige M Macauley, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 500 Pineview Dr Ste 205, Kernersville, NC 27284 Phone: 336-329-3295 Fax: 336-355-5204 | |
Mrs. Katelyn Shinn Hedrick, RDN, IBCLC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 717 Graves St, Kernersville, NC 27284 Phone: 336-596-4111 |