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NPI Code Detail

MEDICARE: DR. CASSANDRA LOIS TAYLOR CRNA, DNP

MEDICARE: DR. CASSANDRA LOIS TAYLOR CRNA, DNP
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
1367500000XCertified Registered Nurse Anesthetist34325WV

General Provider Information

NPI Number : 1134263809
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CASSANDRA LOIS TAYLOR CRNA, DNP
Provider Business Mailing Address
First Line : 1578 LEE ST E
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-2404
Country : US
Telephone Number : 304-345-9447
Fax Number :
Provider Business Practice Location Address
First Line : 3110 MACCORKLE AVE SE
Second Line : ROOM 2041
City : CHARLESTON
State : WV
Zip : 25304-1210
Country : US
Telephone Number : 304-388-9952
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 07/08/2007

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