Provider Demographics
NPI:1235467598
Name:TAYLOR, JESSIE CATHERINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JESSIE
Middle Name:CATHERINE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:133 ORNAC
Mailing Address - Street 2:EMERSON HOSPITAL PEDIATRIC DEPT.
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4159
Mailing Address - Country:US
Mailing Address - Phone:978-369-1400
Mailing Address - Fax:
Practice Address - Street 1:133 ORNAC
Practice Address - Street 2:EMERSON HOSPITAL PEDIATRIC DEPT.
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4159
Practice Address - Country:US
Practice Address - Phone:978-369-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-25
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN273555363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics