Provider Demographics
NPI:1801882766
Name:TAYLOR, KATHY O'CONNOR (RPH)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:O'CONNOR
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 WATERVILLE MONCLOVA RD
Mailing Address - Street 2:
Mailing Address - City:MONCLOVA
Mailing Address - State:OH
Mailing Address - Zip Code:43542-9779
Mailing Address - Country:US
Mailing Address - Phone:419-878-7582
Mailing Address - Fax:
Practice Address - Street 1:5620 WATERVILLE MONCLOVA RD
Practice Address - Street 2:
Practice Address - City:MONCLOVA
Practice Address - State:OH
Practice Address - Zip Code:43542-9779
Practice Address - Country:US
Practice Address - Phone:419-878-7582
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020321771835P1200X
OH032154101835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy