Provider Demographics
NPI:1265235915
Name:MOORE, TAYLOR KEANA (RN)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:KEANA
Last Name:MOORE
Suffix:
Gender:
Credentials:RN
Other - Prefix:MS
Other - First Name:TAYLOR
Other - Middle Name:KEANA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:228 STONEBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-5071
Mailing Address - Country:US
Mailing Address - Phone:205-305-2854
Mailing Address - Fax:
Practice Address - Street 1:1802 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1932
Practice Address - Country:US
Practice Address - Phone:205-934-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-173801163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse