Healthcare Provider Details

I. General information

NPI: 1912678897
Provider Name (Legal Business Name): MEAGAN TAYLOR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 BURNETT COURT SUITE 100
DURANGO CO
81301-3647
US

IV. Provider business mailing address

2 BURNETT COURT SUITE 100
DURANGO CO
81301-3647
US

V. Phone/Fax

Practice location:
  • Phone: 970-385-4022
  • Fax: 970-385-4337
Mailing address:
  • Phone: 970-385-4022
  • Fax: 970-385-4337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0008213
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: