Provider Demographics
NPI:1962251561
Name:KOEHLER, TAYLOR LAUREN (RN, BSN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LAUREN
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 315TH AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERIC
Mailing Address - State:WI
Mailing Address - Zip Code:54837-4728
Mailing Address - Country:US
Mailing Address - Phone:715-553-1340
Mailing Address - Fax:
Practice Address - Street 1:993 315TH AVE
Practice Address - Street 2:
Practice Address - City:FREDERIC
Practice Address - State:WI
Practice Address - Zip Code:54837-4728
Practice Address - Country:US
Practice Address - Phone:715-553-1340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI242566163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health