Individual
MISS ILA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2234 LUANN LANE, MADISON, WI 53713
(608) 228-3539
Mailing address
2234 LUANN LANE, MADISON, WI 53713
(608) 228-3539
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
31202
WI
3747A0650X
Attendant Care Provider
31202
WI
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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