Provider Demographics
NPI:1326673856
Name:TAYLOR, MERSEDYS DIARISSE NAKIA
Entity Type:Individual
Prefix:MISS
First Name:MERSEDYS
Middle Name:DIARISSE NAKIA
Last Name:TAYLOR
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 1:5031 57TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1627
Mailing Address - Country:US
Mailing Address - Phone:240-845-4196
Mailing Address - Fax:
Practice Address - Street 1:114 WAYNE PL SE APT 107
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-6120
Practice Address - Country:US
Practice Address - Phone:202-846-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide