Healthcare Provider Details

I. General information

NPI: 1154286326
Provider Name (Legal Business Name): TAYLOR LYNN SHAW CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 6TH ST SW
CANTON OH
44710-1702
US

IV. Provider business mailing address

5100 FRESNO RD NW
DELLROY OH
44620-9692
US

V. Phone/Fax

Practice location:
  • Phone: 330-452-9911
  • Fax:
Mailing address:
  • Phone: 330-324-8087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN.468316
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: