Provider Demographics
NPI:1306145073
Name:TAYLOR, ALFRED SAHR (STNA)
Entity type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:SAHR
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 CROSS COUNTRY DR E
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3578
Mailing Address - Country:US
Mailing Address - Phone:614-316-7302
Mailing Address - Fax:
Practice Address - Street 1:976 CROSS COUNTRY DR E
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3578
Practice Address - Country:US
Practice Address - Phone:614-316-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH320583440602376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide