MEDICARE: TATYANA 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1467319434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATYANA TAYLOR

Provider Business Mailing Address
First Line	:	4723 HENDESON ROAD
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4723 HENDERSON RD
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-2104
Country	:	US
Telephone Number	:	301-455-3286
Fax Number	:

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

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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