Provider Demographics
NPI:1568914893
Name:TAYLOR, JENNIFER LYNN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 CORPORATE PARK RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6562
Mailing Address - Country:US
Mailing Address - Phone:845-227-1770
Mailing Address - Fax:845-227-1782
Practice Address - Street 1:25 CORPORATE PARK RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6562
Practice Address - Country:US
Practice Address - Phone:845-227-1770
Practice Address - Fax:845-227-1782
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY654781163WS0200X
NY654781-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool