Provider Demographics
NPI:1497264196
Name:TAYLOR, MELONY ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MELONY
Middle Name:ANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:FRAZER
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1528
Mailing Address - Country:US
Mailing Address - Phone:610-246-6120
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:FRAZER
Practice Address - State:PA
Practice Address - Zip Code:19355-1528
Practice Address - Country:US
Practice Address - Phone:610-246-6120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAW137223P164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse