Provider Demographics
NPI:1366004715
Name:TAYLOR, SCOTT (FNP)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 SIOUX DR
Mailing Address - Street 2:
Mailing Address - City:RITTMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44270-1919
Mailing Address - Country:US
Mailing Address - Phone:330-621-4860
Mailing Address - Fax:
Practice Address - Street 1:33 NORTH AVE STE 103
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1900
Practice Address - Country:US
Practice Address - Phone:330-633-3883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-06
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily