Provider Demographics
NPI:1922381433
Name:TAYLOR, VAUNE R
Entity Type:Individual
Prefix:
First Name:VAUNE
Middle Name:R
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 1:606 N COUNTY ROAD 900 E
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-5448
Mailing Address - Country:US
Mailing Address - Phone:317-292-4853
Mailing Address - Fax:317-271-9802
Practice Address - Street 1:1516 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1791
Practice Address - Country:US
Practice Address - Phone:317-838-9187
Practice Address - Fax:317-838-7421
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist