Provider Demographics
NPI:1346813649
Name:TAYLOR WHITE, SHAREN BRENDA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:SHAREN
Middle Name:BRENDA
Last Name:TAYLOR WHITE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13908 OWINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-5919
Mailing Address - Country:US
Mailing Address - Phone:301-266-1241
Mailing Address - Fax:301-782-3213
Practice Address - Street 1:13908 OWINGS AVE
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-5919
Practice Address - Country:US
Practice Address - Phone:301-266-1241
Practice Address - Fax:301-782-3213
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR167277163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse