Healthcare Provider Details

I. General information

NPI: 1770074643
Provider Name (Legal Business Name): JENNIFER KAREN TAYLOR DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER KAREN GOSSELIN

II. Dates (important events)

Enumeration Date: 05/25/2018
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WESTAGE BUSINESS CTR DR
FISHKILL NY
12524-2281
US

IV. Provider business mailing address

22 PLEASANT LN
POUGHKEEPSIE NY
12603-5650
US

V. Phone/Fax

Practice location:
  • Phone: 845-592-7780
  • Fax:
Mailing address:
  • Phone: 845-592-7780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF342729-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: