Provider Demographics
NPI:1477247609
Name:TAYLOR, SHAKENA SHAMAE
Entity Type:Individual
Prefix:MRS
First Name:SHAKENA
Middle Name:SHAMAE
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 1:464 INVESTORS PL STE 204AC
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1167
Mailing Address - Country:US
Mailing Address - Phone:757-938-1027
Mailing Address - Fax:757-904-1410
Practice Address - Street 1:464 INVESTORS PL STE 204AC
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1167
Practice Address - Country:US
Practice Address - Phone:757-904-0978
Practice Address - Fax:757-904-1410
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA92-33211404251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health