Provider Demographics
NPI:1831534015
Name:TAYLOR, SHARONDA FOSTER (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SHARONDA
Middle Name:FOSTER
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7459 JUNIPER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-3539
Mailing Address - Country:US
Mailing Address - Phone:901-605-1981
Mailing Address - Fax:
Practice Address - Street 1:7459 JUNIPER RIDGE DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-3539
Practice Address - Country:US
Practice Address - Phone:901-605-1981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000118944163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant