Provider Demographics
NPI:1124803473
Name:TAYLOR, GEORAN
Entity type:Individual
Prefix:
First Name:GEORAN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 SOUTHERN SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20774-6062
Mailing Address - Country:US
Mailing Address - Phone:202-600-5429
Mailing Address - Fax:
Practice Address - Street 1:332 QUACKENBOS ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1654
Practice Address - Country:US
Practice Address - Phone:200-263-5861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant