Provider Demographics
NPI:1063982437
Name:TAYLOR, AMIRA
Entity type:Individual
Prefix:
First Name:AMIRA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 BRIGHTWAY ST
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-4371
Mailing Address - Country:US
Mailing Address - Phone:412-742-2716
Mailing Address - Fax:
Practice Address - Street 1:3939 BRIGHTWAY ST
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4371
Practice Address - Country:US
Practice Address - Phone:412-742-2716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health