Healthcare Provider Details

I. General information

NPI: 1700548344
Provider Name (Legal Business Name): PATRICIA TAYLOR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E BROAD ST
ELYRIA OH
44035-6306
US

IV. Provider business mailing address

2678 OAKLAWN TRL
HINCKLEY OH
44233-9559
US

V. Phone/Fax

Practice location:
  • Phone: 216-926-1793
  • Fax:
Mailing address:
  • Phone: 216-926-1793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN0030002
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLE-00038292
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN0030002
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0030002
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: