Provider Demographics
NPI:1760724868
Name:TAYLOR, VERSEAN LEMAR (LPN)
Entity Type:Individual
Prefix:
First Name:VERSEAN
Middle Name:LEMAR
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 AMBER HILLS DR APT C
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-8532
Mailing Address - Country:US
Mailing Address - Phone:330-252-7171
Mailing Address - Fax:
Practice Address - Street 1:1790 AMBER HILLS DR APT C
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8532
Practice Address - Country:US
Practice Address - Phone:330-252-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH148800164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse