Provider Demographics
NPI:1801162490
Name:KESLER, TAJUANA GREENARD
Entity type:Individual
Prefix:MS
First Name:TAJUANA
Middle Name:GREENARD
Last Name:KESLER
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 1:1008 S MAIN ST. STE.6
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-6457
Mailing Address - Country:US
Mailing Address - Phone:704-232-4554
Mailing Address - Fax:
Practice Address - Street 1:1008 S MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-6457
Practice Address - Country:US
Practice Address - Phone:704-232-4554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC45343747P1801X
NCHC4534374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant