Provider Demographics
NPI:1346813094
Name:WOGENSTAHL, TAYLOR C (NP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:C
Last Name:WOGENSTAHL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 WUNNENBERG WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4863
Mailing Address - Country:US
Mailing Address - Phone:513-860-4600
Mailing Address - Fax:513-860-9059
Practice Address - Street 1:4870 WUNNENBERG WAY
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4863
Practice Address - Country:US
Practice Address - Phone:513-860-4600
Practice Address - Fax:513-860-9059
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN423520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily