Provider Demographics
NPI:1124866579
Name:FLOOD, TAKILAH (CNA)
Entity type:Individual
Prefix:
First Name:TAKILAH
Middle Name:
Last Name:FLOOD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:TAKILAH
Other - Middle Name:
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:912 DEERFIELD TRCE
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7148
Mailing Address - Country:US
Mailing Address - Phone:919-752-7302
Mailing Address - Fax:
Practice Address - Street 1:912 DEERFIELD TRCE
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7148
Practice Address - Country:US
Practice Address - Phone:919-752-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC410346376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide