Provider Demographics
NPI:1154855674
Name:VANNESS, TAYLOR ANNE
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:ANNE
Last Name:VANNESS
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 1:1195 W FREMONT RD APT 11
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-9654
Mailing Address - Country:US
Mailing Address - Phone:419-707-4397
Mailing Address - Fax:
Practice Address - Street 1:1195 W FREMONT RD APT 11
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452
Practice Address - Country:US
Practice Address - Phone:419-707-4397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide