Provider Demographics
NPI:1891375705
Name:TAYLOR, JANIKA (APRN)
Entity Type:Individual
Prefix:
First Name:JANIKA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3179 HARDWOOD HAMMOCK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-7381
Mailing Address - Country:US
Mailing Address - Phone:407-936-8627
Mailing Address - Fax:
Practice Address - Street 1:3179 HARDWOOD HAMMOCK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-7381
Practice Address - Country:US
Practice Address - Phone:407-936-8627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF11200187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily