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NPI Code Detail

MEDICARE: JEREMY TAYLOR

MEDICARE: JEREMY 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1154196350
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY TAYLOR
Provider Business Mailing Address
First Line : 4423 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3703
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4423 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3703
Country : US
Telephone Number : 817-575-1113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2023
Last Update Date : 11/17/2023

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Directions to “ JEREMY TAYLOR ” Practice Location

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