Provider Demographics
NPI:1912772674
Name:TAYLOR, ELIZABETH COLLEEN
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:COLLEEN
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 1:18323 ROY CROFT DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-1662
Mailing Address - Country:US
Mailing Address - Phone:240-329-8916
Mailing Address - Fax:
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 107
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6734
Practice Address - Country:US
Practice Address - Phone:301-714-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife