Provider Demographics
NPI:1972313906
Name:TAYLOR, JAMIELLA MONET
Entity type:Individual
Prefix:
First Name:JAMIELLA
Middle Name:MONET
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 1:636 WAVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-3836
Mailing Address - Country:US
Mailing Address - Phone:419-705-9168
Mailing Address - Fax:
Practice Address - Street 1:3601 HILL AVE LOT 218
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-4721
Practice Address - Country:US
Practice Address - Phone:567-315-2386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-11
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator