Healthcare Provider Details

I. General information

NPI: 1235750308
Provider Name (Legal Business Name): TAYLOR NICOLE BOSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8240 NORTHCREEK DR
CINCINNATI OH
45236-2377
US

IV. Provider business mailing address

8240 NORTHCREEK DR
CINCINNATI OH
45236-2377
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2300
  • Fax: 513-856-9890
Mailing address:
  • Phone: 513-246-2300
  • Fax: 513-856-9890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35.155950
License Number StateOH
# 2
Primary TaxonomyN
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: