Provider Demographics
NPI:1295842011
Name:TAYLOR, YVONNE M (APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 WOODHALL ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2222
Mailing Address - Country:US
Mailing Address - Phone:313-671-3252
Mailing Address - Fax:
Practice Address - Street 1:4303 WOODHALL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2222
Practice Address - Country:US
Practice Address - Phone:313-671-3252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704220247363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology