MEDICARE: BRIANA VERNELL 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1881227361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANA VERNELL TAYLOR

Provider Business Mailing Address
First Line	:	5938 AGUSTA ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-3606
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5938 AGUSTA ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-3606
Country	:	US
Telephone Number	:	717-269-7679
Fax Number	:

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

Provider Enumeration Date	:	02/12/2020
Last Update Date	:	02/12/2020

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Directions to “ BRIANA VERNELL TAYLOR ” Practice Location

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