MEDICARE: DR. JESSICA TAYLOR MD

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	390200000X	Student in an Organized Health Care Education/Training Program		LA

General Provider Information

NPI Number	:	1538002787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA TAYLOR MD

Provider Business Mailing Address
First Line	:	436 JORDAN DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4079
Country	:	US
Telephone Number	:	318-237-5334
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 KINGS HWY
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-4228
Country	:	US
Telephone Number	:	131-862-6404
Fax Number	:

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

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ DR. JESSICA TAYLOR MD” Practice Location

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