Provider Demographics
NPI:1316367642
Name:TAYLOR, JENNIFER (MSN,FNP-BC,AGPCNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSN,FNP-BC,AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636745
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6745
Mailing Address - Country:US
Mailing Address - Phone:513-853-4749
Mailing Address - Fax:
Practice Address - Street 1:10494 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5214
Practice Address - Country:US
Practice Address - Phone:513-865-2271
Practice Address - Fax:513-865-3162
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15788-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner