Provider Demographics
NPI:1699103234
Name:TAYLOR-BRYAN, ASHLEY (LPN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TAYLOR-BRYAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 PEDDICORD AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-1189
Mailing Address - Country:US
Mailing Address - Phone:740-572-2540
Mailing Address - Fax:
Practice Address - Street 1:628 PEDDICORD AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-1189
Practice Address - Country:US
Practice Address - Phone:740-572-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.147323-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse