Healthcare Provider Details

I. General information

NPI: 1245906460
Provider Name (Legal Business Name): TAYLOR LYNN GEPHART CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR LYNN TIMMERMAN

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3224 JARVIS RD
LIMA OH
45807-2213
US

IV. Provider business mailing address

10509 PATTERSON HALPIN RD
SIDNEY OH
45365-8629
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-5757
  • Fax:
Mailing address:
  • Phone: 937-638-4795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0029062
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: