Healthcare Provider Details

I. General information

NPI: 1669239638
Provider Name (Legal Business Name): ELIZABETH L KERR-TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH L TAYLOR

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

972 COUNTRYRIDGE LN
CINCINNATI OH
45233-4805
US

IV. Provider business mailing address

972 COUNTRYRIDGE LN
CINCINNATI OH
45233-4805
US

V. Phone/Fax

Practice location:
  • Phone: 513-386-9085
  • Fax: 513-513-1308
Mailing address:
  • Phone: 513-386-9085
  • Fax: 513-513-1308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number1661HHN
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: