Provider Demographics
NPI:1770260689
Name:TAYLOR, VENSON JEFFERON JR (RN)
Entity type:Individual
Prefix:MR
First Name:VENSON
Middle Name:JEFFERON
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 W TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-1826
Mailing Address - Country:US
Mailing Address - Phone:203-424-8349
Mailing Address - Fax:
Practice Address - Street 1:370 JAMES ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-3089
Practice Address - Country:US
Practice Address - Phone:203-874-6667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT110440163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse