Healthcare Provider Details

I. General information

NPI: 1184013591
Provider Name (Legal Business Name): HANNAH TAYLOR CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2015
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 N COUNTY ROAD 25A
TROY OH
45373-1337
US

IV. Provider business mailing address

3130 N COUNTY ROAD 25A
TROY OH
45373-1337
US

V. Phone/Fax

Practice location:
  • Phone: 937-335-3561
  • Fax:
Mailing address:
  • Phone: 937-335-3561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN.325961
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: