Provider Demographics
NPI:1568025393
Name:KIEFFER, TAYLOR (AUD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:KIEFFER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 US HIGHWAY 1 S STE 121
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-4276
Mailing Address - Country:US
Mailing Address - Phone:904-824-6007
Mailing Address - Fax:
Practice Address - Street 1:1835 US HIGHWAY 1 S STE 121
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4276
Practice Address - Country:US
Practice Address - Phone:904-824-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter