Provider Demographics
NPI:1679853154
Name:TAYLOR, JOANNA KATHERINE (RN)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:KATHERINE
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 1:12 CABOT DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-1630
Mailing Address - Country:US
Mailing Address - Phone:603-521-5580
Mailing Address - Fax:
Practice Address - Street 1:12 CABOT DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-1630
Practice Address - Country:US
Practice Address - Phone:603-521-5580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH064431-21163W00000X
NH038239-24376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No163W00000XNursing Service ProvidersRegistered Nurse