Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | COA.13702-NP | OH |
NPI | 1043569577 |
---|---|
Provider Name | Mrs. Cheryl Denise Taylor |
First Address | Woodmere, OH 44122-4414 |
Second Address | Ravenna, OH 44266-3929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2012 |
Last Update Date | 30/08/2012 |