Provider Demographics
NPI:1750360715
Name:TAYLOR-HERRING, JAIDA (MSN, ARNP, CNM)
Entity type:Individual
Prefix:
First Name:JAIDA
Middle Name:
Last Name:TAYLOR-HERRING
Suffix:
Gender:F
Credentials:MSN, ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10549
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-0549
Mailing Address - Country:US
Mailing Address - Phone:727-821-6701
Mailing Address - Fax:727-824-8137
Practice Address - Street 1:1344 22ND ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712
Practice Address - Country:US
Practice Address - Phone:727-821-6701
Practice Address - Fax:727-824-8137
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3220252176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307307600Medicaid
FL307307600Medicaid