Provider Demographics
NPI:1750575718
Name:TAYLOR, VANESSA LYNN LOUISE
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:LYNN LOUISE
Last Name:TAYLOR
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 1:6441 COACH CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2367
Mailing Address - Country:US
Mailing Address - Phone:907-344-2799
Mailing Address - Fax:907-344-2799
Practice Address - Street 1:6441 COACH CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2367
Practice Address - Country:US
Practice Address - Phone:907-344-2799
Practice Address - Fax:907-344-2799
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility