1134892300 NPI number — TAYLOR LYNN ROBINSON

Table of content: TAYLOR LYNN ROBINSON (NPI 1134892300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134892300 NPI number — TAYLOR LYNN ROBINSON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
TAYLOR
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134892300
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5240 E GALBRAITH RD STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45236-2879
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-721-7533
Provider Business Mailing Address Fax Number:
513-721-1036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5240 E GALBRAITH RD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45236-2879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-721-7533
Provider Business Practice Location Address Fax Number:
513-721-1036
Provider Enumeration Date:
07/26/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  0028408 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: APRN.CNP0028408 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0480784 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".