Provider Demographics
NPI:1104497494
Name:TAYLOR, ANNE (NP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 SISKIYOU BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2198
Mailing Address - Country:US
Mailing Address - Phone:541-482-2716
Mailing Address - Fax:541-488-5461
Practice Address - Street 1:935 SISKIYOU BLVD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2198
Practice Address - Country:US
Practice Address - Phone:541-482-2716
Practice Address - Fax:541-488-5461
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202106304NP207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine