Provider Demographics
NPI:1356699680
Name:TAYLOR, MARCIA RACHAEL (CRNP)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:RACHAEL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:2ND FLOOR DIVISION OF NEONATOLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-3083
Mailing Address - Fax:410-543-7741
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:2ND FLOOR DIVISION OF NEONATOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-3083
Practice Address - Fax:410-543-7741
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010127363LP0222X
PASP018860363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care