Provider Demographics
NPI:1922563642
Name:TAYLOR, JAMESHA SURENA
Entity Type:Individual
Prefix:
First Name:JAMESHA
Middle Name:SURENA
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 1:2688 SHERIDAN RD SE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5294
Mailing Address - Country:US
Mailing Address - Phone:202-570-3765
Mailing Address - Fax:202-248-6269
Practice Address - Street 1:2688 SHERIDAN RD SE APT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5294
Practice Address - Country:US
Practice Address - Phone:202-570-3765
Practice Address - Fax:202-248-6269
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant