Provider Demographics
NPI:1801320551
Name:TAYLOR, JESSICA A (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 SPEER RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1044
Mailing Address - Country:US
Mailing Address - Phone:410-778-9300
Mailing Address - Fax:844-899-3778
Practice Address - Street 1:120 SPEER RD BLDG B
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1044
Practice Address - Country:US
Practice Address - Phone:410-778-9300
Practice Address - Fax:844-899-3778
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELT-0000104364SC1501X, 364S00000X
MDR192018363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist