Provider Demographics
NPI:1932749298
Name:TAYLOR, LEKIRA ELMORE
Entity Type:Individual
Prefix:
First Name:LEKIRA
Middle Name:ELMORE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEKIRA
Other - Middle Name:CIARA
Other - Last Name:ELMORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA/HHA
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32041-0175
Mailing Address - Country:US
Mailing Address - Phone:912-227-6182
Mailing Address - Fax:
Practice Address - Street 1:951421 BRIDGE PARKWAY
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32097
Practice Address - Country:US
Practice Address - Phone:912-227-6182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL373276376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide