Healthcare Provider Details

I. General information

NPI: 1003721168
Provider Name (Legal Business Name): KEISHA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5028 CALL PL SE APT 104
WASHINGTON DC
20019-7691
US

IV. Provider business mailing address

5028 CALL PL SE APT 104
WASHINGTON DC
20019-7691
US

V. Phone/Fax

Practice location:
  • Phone: 202-905-5942
  • Fax: 240-398-0206
Mailing address:
  • Phone: 202-905-5942
  • Fax: 240-398-0206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: