Provider Demographics
NPI:1457570822
Name:TAYLOR, ERICA A (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 KENTSHIRE DR
Mailing Address - Street 2:# 101
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2989
Mailing Address - Country:US
Mailing Address - Phone:937-496-2000
Mailing Address - Fax:937-999-4216
Practice Address - Street 1:5600 KENTSHIRE DR
Practice Address - Street 2:STE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-2989
Practice Address - Country:US
Practice Address - Phone:937-734-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021322363L00000X
OHCNP.021322363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily