Provider Demographics
NPI:1871366674
Name:TAYLOR, MEGAN SHAE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:SHAE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 TAYLOR TRL
Mailing Address - Street 2:
Mailing Address - City:THORNHURST
Mailing Address - State:PA
Mailing Address - Zip Code:18424-8056
Mailing Address - Country:US
Mailing Address - Phone:570-955-8152
Mailing Address - Fax:
Practice Address - Street 1:420 SUPREME CT
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302-6800
Practice Address - Country:US
Practice Address - Phone:570-213-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily