Provider Demographics
NPI:1225756737
Name:WHITTLE, TAYLOR MICHELE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELE
Last Name:WHITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663
Mailing Address - Country:US
Mailing Address - Phone:337-527-6371
Mailing Address - Fax:337-528-2034
Practice Address - Street 1:600 CYPRESS ST.
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663
Practice Address - Country:US
Practice Address - Phone:337-527-6371
Practice Address - Fax:337-528-2034
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide