Provider Demographics
NPI:1306093703
Name:TAYLOR, CHARIS (LPN)
Entity type:Individual
Prefix:
First Name:CHARIS
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 S WINSTON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-1647
Mailing Address - Country:US
Mailing Address - Phone:720-257-4461
Mailing Address - Fax:
Practice Address - Street 1:3049 S WINSTON ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-1647
Practice Address - Country:US
Practice Address - Phone:720-257-4461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41172164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse