Provider Demographics
NPI:1558042044
Name:KOHN, TAYLOR DEAN (NP)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:DEAN
Last Name:KOHN
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 1:1001 BOULDERS PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5513
Mailing Address - Country:US
Mailing Address - Phone:804-410-9749
Mailing Address - Fax:
Practice Address - Street 1:1001 BOULDERS PKWY STE 110
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-5513
Practice Address - Country:US
Practice Address - Phone:804-410-9749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187644363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology