Healthcare Provider Details

I. General information

NPI: 1407061500
Provider Name (Legal Business Name): JANIS WIEST TAYLOR CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 S BEAVER ST
YORK PA
17403-2209
US

IV. Provider business mailing address

28 GATEWAY RD
YORK PA
17403-4813
US

V. Phone/Fax

Practice location:
  • Phone: 717-845-9683
  • Fax: 717-843-2698
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP006656B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: