Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AG06190304 | OH |
NPI | 1003477688 |
---|---|
Provider Name | Taylor Moyer |
First Address | New Philadelphia, OH 44663-9367 |
Second Address | New Philadelphia, OH 44663-9367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2019 |
Last Update Date | 25/06/2019 |