Provider Demographics
NPI:1447633300
Name:TAYLOR, DELORES (HHA7531 /07/12/11)
Entity type:Individual
Prefix:
First Name:DELORES
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:HHA7531 /07/12/11
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 NELSON PL SE
Mailing Address - Street 2:#2
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-7725
Mailing Address - Country:US
Mailing Address - Phone:202-529-0110
Mailing Address - Fax:
Practice Address - Street 1:1010 WISCONSIN AVE NW
Practice Address - Street 2:300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-3603
Practice Address - Country:US
Practice Address - Phone:202-289-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA7531374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide