Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 670985 | TX |
NPI | 1346570793 |
---|---|
Provider Name | Mrs. Lenea Marie Taylor |
First Address | San Antonio, TX 78249-3888 |
Second Address | San Antonio, TX 78229-3646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2010 |
Last Update Date | 07/01/2010 |