Individual
TAYLOR JOHNSON ANTONELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
43 FOUNDRY AVE STE 110, WALTHAM, MA 02453-8313
(781) 693-3800
(617) 562-1398
Mailing address
43 FOUNDRY AVE, WALTHAM, MA 02453-8313
(781) 693-3800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2350068
MA
Other
Enumeration date
08/02/2022
Last updated
04/10/2026
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