Provider Demographics
NPI:1467080366
Name:BLAND-BALL, TAYLOR NICHOLE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NICHOLE
Last Name:BLAND-BALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROCK ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-4644
Mailing Address - Country:US
Mailing Address - Phone:352-942-2427
Mailing Address - Fax:
Practice Address - Street 1:10 ROCK ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-4644
Practice Address - Country:US
Practice Address - Phone:352-942-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty