Provider Demographics
NPI:1659521086
Name:TAYLOR, JONATHAN E SR (REGISTERED NURSE)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:E
Last Name:TAYLOR
Suffix:SR
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ROYAL RDG
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45327-1379
Mailing Address - Country:US
Mailing Address - Phone:937-855-2044
Mailing Address - Fax:937-855-2045
Practice Address - Street 1:60 ROYAL RDG
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:OH
Practice Address - Zip Code:45327-1379
Practice Address - Country:US
Practice Address - Phone:937-855-2044
Practice Address - Fax:937-855-2045
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH210752163W00000X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator