Provider Demographics
NPI:1851919559
Name:TAYLOR, BRENDA SCOTT
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:SCOTT
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 1:11306 BRIARMONT RD APT 203
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3760
Mailing Address - Country:US
Mailing Address - Phone:804-855-7304
Mailing Address - Fax:804-594-5699
Practice Address - Street 1:11306 BRIARMONT RD APT 230
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-3760
Practice Address - Country:US
Practice Address - Phone:804-855-7304
Practice Address - Fax:804-594-5699
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No172A00000XOther Service ProvidersDriver