Provider Demographics
NPI:1316721343
Name:TAYLOR, SHANNON LEIGH (RN)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:LEIGH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:SHANNON
Other - Middle Name:LEIGH
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:394 ADAMLE DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2010
Mailing Address - Country:US
Mailing Address - Phone:330-690-1400
Mailing Address - Fax:
Practice Address - Street 1:10 PENFIELD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2912
Practice Address - Country:US
Practice Address - Phone:330-762-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN351116163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse