Provider Demographics
NPI:1962154088
Name:TAYLOR, KRISTINA GAIL (CNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:GAIL
Last Name:TAYLOR
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:G
Other - Last Name:DENNISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5383 BLOOMINGGROVE RD
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-9545
Mailing Address - Country:US
Mailing Address - Phone:419-563-4886
Mailing Address - Fax:
Practice Address - Street 1:5383 BLOOMINGGROVE RD
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-9545
Practice Address - Country:US
Practice Address - Phone:419-563-4886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030628363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily