Provider Demographics
NPI:1073252425
Name:OLIVER, TAYLOR ANN
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:OLIVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 JUDITH DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-2007
Mailing Address - Country:US
Mailing Address - Phone:203-275-5671
Mailing Address - Fax:
Practice Address - Street 1:34 WILDWOOD AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2102
Practice Address - Country:US
Practice Address - Phone:203-245-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program