Provider Demographics
NPI:1609918192
Name:TAYLOR, VANESSA GAYLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:GAYLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 MOUND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1441
Mailing Address - Country:US
Mailing Address - Phone:937-833-6266
Mailing Address - Fax:937-833-5683
Practice Address - Street 1:72 MOUND ST
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-1441
Practice Address - Country:US
Practice Address - Phone:937-833-6266
Practice Address - Fax:937-833-5683
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-251166163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2705077OtherRN INDEPENDENT PROVIDER