Healthcare Provider Details

I. General information

NPI: 1558227900
Provider Name (Legal Business Name): JESSICA ANNMARIE TAURIAINEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LINCOLN SQ
WORCESTER MA
01608-1135
US

IV. Provider business mailing address

53074 RIDGEWOOD DR
CHESTERFIELD MI
48051-3907
US

V. Phone/Fax

Practice location:
  • Phone: 508-373-5679
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: