Healthcare Provider Details

I. General information

NPI: 1356796924
Provider Name (Legal Business Name): ANGELA TAYLOR DCN, MS, CNS, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 ROLAND AVE
BALTIMORE MD
21210-1309
US

IV. Provider business mailing address

5801 ROLAND AVE
BALTIMORE MD
21210-1309
US

V. Phone/Fax

Practice location:
  • Phone: 410-561-6241
  • Fax:
Mailing address:
  • Phone: 410-561-6241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX4804
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: