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NPI Code Detail

MEDICARE: JESSICA TAYLOR

MEDICARE: JESSICA TAYLOR
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
1374700000XTechnician
2390200000XStudent in an Organized Health Care Education/Training ProgramMI

General Provider Information

NPI Number : 1477118404
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA TAYLOR
Provider Business Mailing Address
First Line : 3475 PLYMOUTH RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2550
Country : US
Telephone Number : 517-332-1616
Fax Number :
Provider Business Practice Location Address
First Line : 3475 PLYMOUTH RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2550
Country : US
Telephone Number : 517-332-1616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2019
Last Update Date : 11/01/2023

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Directions to “ JESSICA TAYLOR ” Practice Location

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