Provider Demographics
NPI:1194329730
Name:TAYLOR-RICHARDS, BEVERLY DIANE
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:DIANE
Last Name:TAYLOR-RICHARDS
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 1:8368 COPLEY RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-7271
Mailing Address - Country:US
Mailing Address - Phone:304-269-5349
Mailing Address - Fax:304-471-2488
Practice Address - Street 1:8 N SPRING ST
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2720
Practice Address - Country:US
Practice Address - Phone:304-472-0395
Practice Address - Fax:304-471-2488
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker