MEDICARE: MRS. DE'ANNA DARCELL TAYLOR LPN

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	311ZA0620X	Adult Care Home Facility	123827	OH

General Provider Information

NPI Number	:	1912162603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DE'ANNA DARCELL TAYLOR LPN

Provider Business Mailing Address
First Line	:	924 CADDO AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-1009
Country	:	US
Telephone Number	:	330-815-0594
Fax Number	:

Provider Business Practice Location Address
First Line	:	924 CADDO AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-1009
Country	:	US
Telephone Number	:	330-815-0594
Fax Number	:

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

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	01/25/2011

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