Provider Demographics
NPI:1083316491
Name:DELLAGROTTA, TAYLOR (RN)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:DELLAGROTTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 COBBLESTONE TER
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-8576
Mailing Address - Country:US
Mailing Address - Phone:401-222-0944
Mailing Address - Fax:
Practice Address - Street 1:52 COBBLESTONE TER
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-8576
Practice Address - Country:US
Practice Address - Phone:401-222-0944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN62384163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse