Provider Demographics
NPI:1295541670
Name:TAYLOR, KATHRYN RAE (PA-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RAE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7809 COUNTY ROAD 9
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:OH
Mailing Address - Zip Code:43543-9319
Mailing Address - Country:US
Mailing Address - Phone:567-239-5122
Mailing Address - Fax:
Practice Address - Street 1:22 TURTLE CREEK CIR
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-8591
Practice Address - Country:US
Practice Address - Phone:419-825-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant