Individual ProviderAlyssa Rose TaylorSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2104 Northdale Blvd NW Ste 100, Coon Rapids, MN 55433(763) 755-5495(612) 558-7932PECOS EnrollmentBased on the most recent information from CMS, provider Alyssa Rose Taylor does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1205334190Provider TypeIndividualFull NameTaylor, Alyssa RoseGenderFemaleSole ProprietorNoEnumeration Date1/25/2018Last Updated7/10/2018Contact InformationPractice LocationPractice Address2104 Northdale Blvd NW Ste 100, Coon Rapids, MN 55433Phone(763) 755-5495FaxUnlisted FaxMailing LocationMailing Address20540 Georgia Ave N, Forest Lake, MN 55025-8009Phone(612) 558-7932FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2255A2300XPrimaryDescriptionSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense2000033575Minnesota