Provider Demographics
NPI:1215614417
Name:TAYLOR, JOANA (PMHNP)
Entity type:Individual
Prefix:
First Name:JOANA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7914 AYLESFORD LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5564
Mailing Address - Country:US
Mailing Address - Phone:856-264-9082
Mailing Address - Fax:
Practice Address - Street 1:7914 AYLESFORD LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5564
Practice Address - Country:US
Practice Address - Phone:856-264-9082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1040257363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health