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General NPI Number Information
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NPI Number | 1477451805
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Entity Type | Individual
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Provider Name | MR. JASON MIRON TAYLOR SR.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2026
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Last Update Date | 10/27/2026
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Provider Practice Location Address
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Address Line | 4265 45TH ST S STE 137
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City | FARGO
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State | ND
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Zip | 58104-4326
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Country | US
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Telephone | 701-237-9977
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 PENN AVE S STE 124
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1319
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Country | US
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Telephone | 612-500-7832
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | H-0467
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HID-1028
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License Number State | MN
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