Provider Demographics
NPI:1780747766
Name:TAYLOR, VANESSA GEAN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:GEAN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:GEAN
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 VENTURA STREET
Mailing Address - Street 2:APT #1
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124
Mailing Address - Country:US
Mailing Address - Phone:617-298-5372
Mailing Address - Fax:
Practice Address - Street 1:1425 BLUE HILL AVENUE
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126
Practice Address - Country:US
Practice Address - Phone:617-296-0061
Practice Address - Fax:617-296-5408
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252443163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse