Healthcare Provider Details

I. General information

NPI: 1497361901
Provider Name (Legal Business Name): TAYLOR LEANN WEBB-SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAYLOR LEANN WEBB

II. Dates (important events)

Enumeration Date: 09/20/2020
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NATIONAL CHAMPIONSHIP DR
TUCSON AZ
85721-0001
US

IV. Provider business mailing address

3149 S AUSTIN POINT DR APT 2206
TUCSON AZ
85730-6122
US

V. Phone/Fax

Practice location:
  • Phone: 704-681-1425
  • Fax:
Mailing address:
  • Phone: 704-681-1425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberATR-009429
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: