Provider Demographics
NPI:1740693654
Name:TAYLOR, ASHLEY GREGG (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:GREGG
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:GREGG
Other - Last Name:DURAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1397
Mailing Address - Country:US
Mailing Address - Phone:614-839-2128
Mailing Address - Fax:614-823-8881
Practice Address - Street 1:5040 FOREST DR
Practice Address - Street 2:SUITE 300
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8167
Practice Address - Country:US
Practice Address - Phone:614-839-2128
Practice Address - Fax:614-823-8881
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.362051163W00000X
OHCOA.16197-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0109844Medicaid
OHH361180OtherMEDICARE PTAN
OHH361180OtherMEDICARE PTAN