Provider Demographics
NPI:1134873615
Name:LANESE, TAYLOR (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:
Last Name:LANESE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:BAUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3508 DAUPHIN DR NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-2802
Mailing Address - Country:US
Mailing Address - Phone:440-334-6439
Mailing Address - Fax:
Practice Address - Street 1:2600 6TH ST SW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710-1702
Practice Address - Country:US
Practice Address - Phone:330-363-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.451003163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine