Basic Information
| Provider Information | |||||||||
| NPI: | 1902443468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAMRON | ||||||||
| FirstName: | TAYLOR | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 ROSS PARK BLVD STE G3 | ||||||||
| Address2: | |||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402665969 | ||||||||
| FaxNumber: | 7402665970 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 ROSS PARK BLVD STE G-3 | ||||||||
| Address2: | |||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402665969 | ||||||||
| FaxNumber: | 7402665970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2019 | ||||||||
| LastUpdateDate: | 10/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN.CNP.025822 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0383854 | 05 | OH | MEDICAID |