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NPI Code Detail

MEDICARE: ALYSSA MARIE TAYLOR PMHNP

MEDICARE: ALYSSA MARIE TAYLOR PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0041268OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083435465
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MARIE TAYLOR PMHNP
Provider Business Mailing Address
First Line : 3128 DENVER DR
Second Line :
City : POLAND
State : OH
Zip : 44514-2437
Country : US
Telephone Number : 330-219-6050
Fax Number :
Provider Business Practice Location Address
First Line : 165 E PARK AVE
Second Line :
City : NILES
State : OH
Zip : 44446-2352
Country : US
Telephone Number : 330-544-8005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2024
Last Update Date : 01/21/2026

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