Provider Demographics
NPI:1194080325
Name:TAYLOR, RITA L
Entity type:Individual
Prefix:MISS
First Name:RITA
Middle Name:L
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 1:4139 SOUTHERN AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-6893
Mailing Address - Country:US
Mailing Address - Phone:202-718-2595
Mailing Address - Fax:
Practice Address - Street 1:4139 SOUTHERN AVE APT 202
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-6893
Practice Address - Country:US
Practice Address - Phone:202-718-2595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide