Provider Demographics
NPI:1194764316
Name:TAYLOR, DEAN (CRNA)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN542565367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50055813OtherCAPITAL BLUE CROSS
PA2088291000OtherINDEPENDENCE BLUE CROSS
PA7383782OtherAETNA-NON HMO
PA001399578OtherHIGHMARK
PA1148037OtherAETNA-HMO
PA430075866OtherRR MEDICARE
PA105003OtherGEISINGER
PA50055813OtherKEYSTONE HEALTH PLAN CENTRAL
PA2088291000OtherINDEPENDENCE BLUE CROSS