Healthcare Provider Details

I. General information

NPI: 1710862958
Provider Name (Legal Business Name): TAYLOR MORGAN SLACK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E BROAD ST
COLUMBUS OH
43213-1570
US

IV. Provider business mailing address

1980 BLUE VALLEY RD SE
LANCASTER OH
43130-9085
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0040323
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number460063
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: