Individual
LACONYA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4140 PATTERSON AVE, BALTIMORE, MD 21215-2254
(410) 585-1900
Mailing address
800 BRICKSTON RD, REISTERSTOWN, MD 21136-6402
(443) 306-0476
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R182823
MD
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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