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General NPI Number Information
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NPI Number | 1669836771
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Entity Type | Individual
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Provider Name | TAYLOR CLEARY JUNOD CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 1500 WALNUT ST STE 603
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3516
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Country | US
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Telephone | 267-754-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 4527 E THOMPSON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19137-2003
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Country | US
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Telephone | 215-535-1275
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ15395800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 312432
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LP0010799
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R268993
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP015859
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP015859
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License Number State | PA
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