Provider Demographics
NPI:1649976325
Name:JEFFERSON, TAYLOR
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:
Last Name:JEFFERSON
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 1:1901 WATERSIDE VILLAGE DR APT 142
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-6914
Mailing Address - Country:US
Mailing Address - Phone:832-451-8516
Mailing Address - Fax:
Practice Address - Street 1:1901 WATERSIDE VILLAGE DR APT 142
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-6914
Practice Address - Country:US
Practice Address - Phone:832-451-8516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula