Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 020336 | OH |
N | 111NI0900X | Internist | 020336 | OH |
N | 207R00000X | Internist | R229326 | MD |
N | 111NI0900X | Internist | R229326 | MD |
N | 207RG0300X | Geriatric Medicine | R229326 | MD |
N | 363L00000X | Nurse Practitioner | 020336 | OH |
N | 363L00000X | Nurse Practitioner | R229326 | MD |
N | 363LA2200X | Nurse Practitioner - Adult Health | 020336 | OH |
N | 363LA2200X | Nurse Practitioner - Adult Health | R229326 | MD |
N | 363LC1500X | Nurse Practitioner - Community Health | 020336 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | 020336 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | R229326 | MD |
N | 363LP2300X | Nurse Practitioner - Primary Care | 020336 | OH |
Y | 363LP2300X | Nurse Practitioner - Primary Care | R229326 | MD |
NPI | 1295045755 |
---|---|
Provider Name | Elaine Taylor |
First Address | Laurel, MD 20708-1102 |
Second Address | Laurel, MD 20708-1102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2010 |
Last Update Date | 09/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0241911 | (05) | OH |
205DF9EB | (05) | MD |