Provider Demographics
NPI:1467169359
Name:TAYLOR, TANYA SUZETTE (RN)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:SUZETTE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:SUZETTE
Other - Last Name:GLOVER-TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:213 SCOTISH DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8757
Mailing Address - Country:US
Mailing Address - Phone:215-817-8322
Mailing Address - Fax:
Practice Address - Street 1:1601 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4917
Practice Address - Country:US
Practice Address - Phone:302-994-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0039130163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice