Provider Demographics
NPI:1700062866
Name:TAYLOR, CATHY LYNN (RN,BC, MSN, CPNP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN,BC, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:390 VINEYARD WAY
Mailing Address - Street 2:SUITE 501
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-8835
Mailing Address - Country:US
Mailing Address - Phone:304-541-6672
Mailing Address - Fax:
Practice Address - Street 1:390 VINEYARD WAY
Practice Address - Street 2:SUITE 501
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-8835
Practice Address - Country:US
Practice Address - Phone:304-541-6672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV47713363LP0200X
PASP013398363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics