1114879848 NPI number — TAYLOR LIANE GOODPASTOR CRNP

Table of content: TAYLOR LIANE GOODPASTOR CRNP (NPI 1114879848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114879848 NPI number — TAYLOR LIANE GOODPASTOR CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOODPASTOR
Provider First Name:
TAYLOR
Provider Middle Name:
LIANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GILLESPIE
Provider Other First Name:
TAYLOR
Provider Other Middle Name:
LIANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1114879848
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1534 BERKLEY ST SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DECATUR
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35603-3177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 7TH ST SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35601-3337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-973-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1-188992 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)