Provider Demographics
NPI:1295348977
Name:TAYLOR, KENAYA JAZMINE (LVN)
Entity type:Individual
Prefix:
First Name:KENAYA
Middle Name:JAZMINE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 FALCON XING
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-4280
Mailing Address - Country:US
Mailing Address - Phone:210-789-8271
Mailing Address - Fax:
Practice Address - Street 1:112 FALCON XING
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-4280
Practice Address - Country:US
Practice Address - Phone:210-789-8271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330532164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse