Provider Demographics
NPI:1467898932
Name:TAYLOR, JOVON MARKEE (STNA)
Entity Type:Individual
Prefix:MR
First Name:JOVON
Middle Name:MARKEE
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 GRACE ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-1917
Mailing Address - Country:US
Mailing Address - Phone:440-840-8071
Mailing Address - Fax:
Practice Address - Street 1:405 GRACE ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-1917
Practice Address - Country:US
Practice Address - Phone:440-840-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401181331210376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide