Provider Demographics
NPI:1235953217
Name:RELLER, TAYLOR LYNN (MLS(ASCP)CM)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LYNN
Last Name:RELLER
Suffix:
Gender:F
Credentials:MLS(ASCP)CM
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:LYNN
Other - Last Name:NORBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7152 41ST ST N
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-7011
Mailing Address - Country:US
Mailing Address - Phone:320-295-0254
Mailing Address - Fax:
Practice Address - Street 1:2101 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2417
Practice Address - Country:US
Practice Address - Phone:701-232-3241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist