Provider Demographics
NPI:1619402419
Name:TAYLOR, KATLIN (RPH)
Entity Type:Individual
Prefix:
First Name:KATLIN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 MARION MOUNT GILEAD RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5822
Mailing Address - Country:US
Mailing Address - Phone:740-389-2144
Mailing Address - Fax:740-389-2737
Practice Address - Street 1:1608 MARION MOUNT GILEAD RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5822
Practice Address - Country:US
Practice Address - Phone:740-389-2144
Practice Address - Fax:740-389-2737
Is Sole Proprietor?:No
Enumeration Date:2017-04-29
Last Update Date:2017-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist