Provider Demographics
NPI:1912162603
Name:TAYLOR, DE'ANNA DARCELL (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DE'ANNA
Middle Name:DARCELL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 CADDO AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-1009
Mailing Address - Country:US
Mailing Address - Phone:330-815-0594
Mailing Address - Fax:
Practice Address - Street 1:924 CADDO AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-1009
Practice Address - Country:US
Practice Address - Phone:330-815-0594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH123827311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home