Provider Demographics
NPI:1407421639
Name:TAYLOR, PORSHA AMBER
Entity type:Individual
Prefix:MS
First Name:PORSHA
Middle Name:AMBER
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 1:1212 BROOKVIEW DR APT 35
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7252
Mailing Address - Country:US
Mailing Address - Phone:419-280-9593
Mailing Address - Fax:
Practice Address - Street 1:1212 BROOKVIEW DR APT 35
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7252
Practice Address - Country:US
Practice Address - Phone:419-280-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health