Healthcare Provider Details

I. General information

NPI: 1720699986
Provider Name (Legal Business Name): TAYLER RENEA YODER C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5655 HUDSON DRIVE STE 301
HUDSON OH
44236-4454
US

IV. Provider business mailing address

2000 AUBURN DR STE 350
BEACHWOOD OH
44122-4327
US

V. Phone/Fax

Practice location:
  • Phone: 330-653-3376
  • Fax: 330-653-3378
Mailing address:
  • Phone: 440-646-1600
  • Fax: 440-646-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0027209
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN.417348
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: