Provider Demographics
NPI:1558588228
Name:TAYLOR, BETH ANN J (MSN, CRNP, CWOCN)
Entity Type:Individual
Prefix:MS
First Name:BETH ANN
Middle Name:J
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSN, CRNP, CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 N FIEDLER RD
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2715
Mailing Address - Country:US
Mailing Address - Phone:215-740-7038
Mailing Address - Fax:215-542-5655
Practice Address - Street 1:1522 N FIEDLER RD
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2715
Practice Address - Country:US
Practice Address - Phone:215-740-7038
Practice Address - Fax:215-542-5655
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005128C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020452Medicare ID - Type Unspecified
PAS65058Medicare UPIN