Provider Demographics
NPI:1154968642
Name:TAYLOR, XAKENDAL
Entity type:Individual
Prefix:MR
First Name:XAKENDAL
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 1:3737 DELACHAISE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-3717
Mailing Address - Country:US
Mailing Address - Phone:504-671-7513
Mailing Address - Fax:
Practice Address - Street 1:3801 CANAL ST STE 325
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6059
Practice Address - Country:US
Practice Address - Phone:504-483-3558
Practice Address - Fax:504-525-4483
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator