Healthcare Provider Details

I. General information

NPI: 1861087231
Provider Name (Legal Business Name): TAYLOR BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR CRUPIE

II. Dates (important events)

Enumeration Date: 03/07/2021
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MICHIGAN AVE
JEANNETTE PA
15644-2433
US

IV. Provider business mailing address

601 MICHIGAN AVE
JEANNETTE PA
15644-2433
US

V. Phone/Fax

Practice location:
  • Phone: 724-523-2323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberOA005691
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: