MEDICARE: MRS. SHEENA 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	372500000X	Chore Provider

General Provider Information

NPI Number	:	1588438782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEENA TAYLOR

Provider Business Mailing Address
First Line	:	815 ROBERT ST S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55107-3230
Country	:	US
Telephone Number	:	612-404-7940
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 ROBERT ST S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55107-3230
Country	:	US
Telephone Number	:	612-404-7940
Fax Number	:

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

Provider Enumeration Date	:	11/08/2023
Last Update Date	:	11/08/2023

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