Provider Demographics
NPI:1376341966
Name:TAYLOR, NAKETA SHARELL (LPN)
Entity type:Individual
Prefix:MS
First Name:NAKETA
Middle Name:SHARELL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:NAKETA
Other - Middle Name:SHARELL
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3020 REEVES AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4233
Mailing Address - Country:US
Mailing Address - Phone:440-787-0323
Mailing Address - Fax:
Practice Address - Street 1:3020 REEVES AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4233
Practice Address - Country:US
Practice Address - Phone:440-787-0323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH181306164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse