Provider Demographics
NPI:1164419024
Name:TAYLOR, JANE COLLERAN (MSN,RN,CPNP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:COLLERAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSN,RN,CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9705 STIPP ST
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4151
Mailing Address - Country:US
Mailing Address - Phone:703-451-3371
Mailing Address - Fax:
Practice Address - Street 1:13407 LYDIA ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5225
Practice Address - Country:US
Practice Address - Phone:301-929-5546
Practice Address - Fax:301-929-5583
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR046298363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics