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NPI Code Detail

MEDICARE: SIMONE SHYANN TAYLOR

MEDICARE: SIMONE SHYANN 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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1215645676
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIMONE SHYANN TAYLOR
Provider Business Mailing Address
First Line : 7375 PRAIRIE FALCON RD STE 160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0818
Country : US
Telephone Number : 725-204-6485
Fax Number :
Provider Business Practice Location Address
First Line : 7375 PRAIRIE FALCON RD STE 160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0818
Country : US
Telephone Number : 725-204-6485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2022
Last Update Date : 11/14/2022

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Directions to “ SIMONE SHYANN TAYLOR ” Practice Location

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