Provider Demographics
NPI:1194888511
Name:TAYLOR, ROSE MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:MARIE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:O CONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:52530 OLD INFIRMARY ROAD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43772-9619
Mailing Address - Country:US
Mailing Address - Phone:740-732-7151
Mailing Address - Fax:740-732-2502
Practice Address - Street 1:52530 OLD INFIRMARY ROAD
Practice Address - Street 2:
Practice Address - City:PLEASANT CITY
Practice Address - State:OH
Practice Address - Zip Code:43772-9619
Practice Address - Country:US
Practice Address - Phone:740-732-7151
Practice Address - Fax:740-732-2502
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH081382164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2262831OtherIP OHIO DEPT OF JOB & FAM