Healthcare Provider Details

I. General information

NPI: 1548663602
Provider Name (Legal Business Name): MEGAN TAYLOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 ROUTE 4 STE 103
SINAJANA GU
96910-3368
US

IV. Provider business mailing address

736 ROUTE 4 STE 103
SINAJANA GU
96910-3368
US

V. Phone/Fax

Practice location:
  • Phone: 671-649-7232
  • Fax:
Mailing address:
  • Phone: 671-649-7232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number398705
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: