Provider Demographics
NPI:1639362825
Name:TAYLOR, RACHELLE DE ANN
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:DE ANN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 N GARDEN CT
Mailing Address - Street 2:APT 1B
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312
Mailing Address - Country:US
Mailing Address - Phone:330-798-0147
Mailing Address - Fax:
Practice Address - Street 1:1920 N GARDEN CT
Practice Address - Street 2:APT 1B
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312
Practice Address - Country:US
Practice Address - Phone:330-798-0147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH37011824376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide