MEDICARE: MS. JENNIFER TAYLOR MSN,FNP-BC,AGPCNP-BC

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
1	363L00000X	Nurse Practitioner	COA.15788-NP	OH

General Provider Information

NPI Number	:	1316367642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER TAYLOR MSN,FNP-BC,AGPCNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 636745
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-6745
Country	:	US
Telephone Number	:	513-853-4749
Fax Number	:

Provider Business Practice Location Address
First Line	:	10494 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5214
Country	:	US
Telephone Number	:	513-865-2271
Fax Number	:	513-865-3162

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2014
Last Update Date	:	03/11/2015

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