Provider Demographics
NPI:1912594375
Name:TAYLOR, SADIE P
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:P
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 TOWNSHIP ROAD 1546
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-8522
Mailing Address - Country:US
Mailing Address - Phone:567-241-8000
Mailing Address - Fax:
Practice Address - Street 1:991 TOWNSHIP ROAD 1546
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-8522
Practice Address - Country:US
Practice Address - Phone:567-241-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0412987376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker