Provider Demographics
NPI:1376844373
Name:TAYLOR, NILA CELEST MARIE
Entity Type:Individual
Prefix:MS
First Name:NILA
Middle Name:CELEST MARIE
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 1:9384 HOYLETON WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6513
Mailing Address - Country:US
Mailing Address - Phone:209-430-5743
Mailing Address - Fax:916-684-0307
Practice Address - Street 1:1515 VALDORA ST APT 702
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-7800
Practice Address - Country:US
Practice Address - Phone:530-400-9752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-06
Last Update Date:2010-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 232995164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse