Provider Demographics
NPI:1740618644
Name:VERNON-TAYLOR, ROSSELLA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROSSELLA
Middle Name:
Last Name:VERNON-TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 UNION ST
Mailing Address - Street 2:APT 2R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3820
Mailing Address - Country:US
Mailing Address - Phone:347-237-7400
Mailing Address - Fax:
Practice Address - Street 1:2122 UNION ST
Practice Address - Street 2:APT 2R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3820
Practice Address - Country:US
Practice Address - Phone:347-237-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313364-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse