Provider Demographics
NPI:1184210189
Name:TAYLOR, AMY J
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:TAYLOR
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 1:66681 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9424
Mailing Address - Country:US
Mailing Address - Phone:304-780-2518
Mailing Address - Fax:
Practice Address - Street 1:66681 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9424
Practice Address - Country:US
Practice Address - Phone:304-780-2518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care