Provider Demographics
NPI:1376862565
Name:TAYLOR, NATALIE PYBAS (OTR/L)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:PYBAS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456-2905
Mailing Address - Country:US
Mailing Address - Phone:606-256-1316
Mailing Address - Fax:
Practice Address - Street 1:20 OAK HILL RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1002
Practice Address - Country:US
Practice Address - Phone:606-678-8566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYRO841174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist