Provider Demographics
NPI:1457570970
Name:TAYLOR, DALLAS MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:DALLAS
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 JAMESTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1812
Mailing Address - Country:US
Mailing Address - Phone:440-365-9554
Mailing Address - Fax:440-365-0574
Practice Address - Street 1:878 JAMESTOWN AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-1812
Practice Address - Country:US
Practice Address - Phone:440-365-9554
Practice Address - Fax:440-365-0574
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN251838163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology