MEDICARE: MISS MERSEDYS DIARISSE NAKIA 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1326673856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MERSEDYS DIARISSE NAKIA TAYLOR

Provider Business Mailing Address
First Line	:	5031 57TH AVE APT 102
Second Line	:
City	:	BLADENSBURG
State	:	MD
Zip	:	20710-1627
Country	:	US
Telephone Number	:	240-845-4196
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 WAYNE PL SE APT 107
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-6120
Country	:	US
Telephone Number	:	202-846-7232
Fax Number	:

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

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	03/05/2020

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