MEDICARE: E IKESHA 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	374J00000X	Doula

General Provider Information

NPI Number	:	1477004174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	E IKESHA TAYLOR

Provider Business Mailing Address
First Line	:	3408 W 47TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-5910
Country	:	US
Telephone Number	:	216-355-1630
Fax Number	:

Provider Business Practice Location Address
First Line	:	3408 W 47TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-5910
Country	:	US
Telephone Number	:	216-355-1630
Fax Number	:

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

Provider Enumeration Date	:	10/18/2016
Last Update Date	:	10/18/2016

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Directions to “ E IKESHA TAYLOR ” Practice Location

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