Provider Demographics
NPI:1760443758
Name:TAYLOR, REBECCA A (RN CNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML5021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-636-5013
Mailing Address - Fax:866-213-7084
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML4002
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-4688
Practice Address - Fax:513-636-7361
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN138375CDA163W00000X
OHCOA05683NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2623898Medicaid