Provider Demographics
NPI:1528857968
Name:DUCHOW, TAYLOR ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:DUCHOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 S HARMON ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-4820
Mailing Address - Country:US
Mailing Address - Phone:715-781-4915
Mailing Address - Fax:
Practice Address - Street 1:180 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-3377
Practice Address - Country:US
Practice Address - Phone:715-781-4915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6830-403174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist