Provider Demographics
NPI:1679393102
Name:TAYLOR, NAZIMAH RACHEL (LAC)
Entity type:Individual
Prefix:
First Name:NAZIMAH
Middle Name:RACHEL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 OLD KAYS MILL RD
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-2046
Mailing Address - Country:US
Mailing Address - Phone:304-283-2431
Mailing Address - Fax:
Practice Address - Street 1:531 OLD WESTMINSTER PIKE STE 203
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6276
Practice Address - Country:US
Practice Address - Phone:410-907-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03138171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist