Provider Demographics
NPI:1003926403
Name:TAYLOR, PATRICIA KAY (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:KAY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:B
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:14205 CLARKSBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:NEW HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43145-9722
Mailing Address - Country:US
Mailing Address - Phone:740-495-5173
Mailing Address - Fax:
Practice Address - Street 1:17273 STATE ROUTE 104
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8608
Practice Address - Country:US
Practice Address - Phone:740-773-1141
Practice Address - Fax:740-772-7132
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1682133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered