Provider Demographics
NPI:1821622929
Name:MESEROLE, TAYLOR (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:MESEROLE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:GIEDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:823 N MARION AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2332
Mailing Address - Country:US
Mailing Address - Phone:815-543-8160
Mailing Address - Fax:
Practice Address - Street 1:823 N MARION AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2332
Practice Address - Country:US
Practice Address - Phone:815-543-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2023-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.301655183500000X
WI19464-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist