Provider Demographics
NPI:1881169787
Name:TAYLOR, LEILANI A
Entity type:Individual
Prefix:
First Name:LEILANI
Middle Name:A
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 1:41863 INSPIRATION TER
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-4618
Mailing Address - Country:US
Mailing Address - Phone:571-271-8405
Mailing Address - Fax:
Practice Address - Street 1:41863 INSPIRATION TER
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-4618
Practice Address - Country:US
Practice Address - Phone:571-271-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide