MEDICARE: SHAWANA TAYLOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1063376366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWANA TAYLOR

Provider Business Mailing Address
First Line	:	3331 N 106TH PLZ APT 1205
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-3641
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3331 N 106TH PLZ APT 1205
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-3641
Country	:	US
Telephone Number	:	720-322-5370
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ SHAWANA TAYLOR ” Practice Location

Language	Start Address	Practice Location

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