Healthcare Provider Details

I. General information

NPI: 1760613541
Provider Name (Legal Business Name): SARAH TAYLOR LINCOLN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH TAYLOR PA-C

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 IMPERIAL DR
HAGERSTOWN MD
21740-6555
US

IV. Provider business mailing address

1165 IMPERIAL DR
HAGERSTOWN MD
21740-6555
US

V. Phone/Fax

Practice location:
  • Phone: 301-800-7770
  • Fax: 301-800-7891
Mailing address:
  • Phone: 301-800-7770
  • Fax: 301-800-7891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0004016
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC0004016
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: