Provider Demographics
NPI:1457184772
Name:TAYLOR, SHAUN PATRICK
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:PATRICK
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 GIEKE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-9612
Mailing Address - Country:US
Mailing Address - Phone:740-208-6330
Mailing Address - Fax:
Practice Address - Street 1:659 GIEKE RIDGE RD
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:OH
Practice Address - Zip Code:45656-9612
Practice Address - Country:US
Practice Address - Phone:740-208-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant