Individual
STACIE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
7350 INDUSTRIAL PARK BLVD, MENTOR, OH 44060-5318
(216) 732-9480
Mailing address
25938 HIGHLAND RD, RICHMOND HEIGHTS, OH 44143-2703
(216) 533-0420
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
COA.16509-NP
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
COA.16509-NP
OH
Other
Enumeration date
12/05/2014
Last updated
06/09/2016
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