Healthcare Provider Details

I. General information

NPI: 1255844668
Provider Name (Legal Business Name): TAYLOR POHLE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAINT VINCENT HEART INSTITUTE-CARDIOLOGY, YELLOWSTONE 2900 12TH AVENUE NORTH, SUITE 204E
BILLINGS MT
59101
US

IV. Provider business mailing address

TAYLOR POHLE, PA-C, ST. VINCENT HEART INSTITUTE-CARDIOL 2900 12TH AVENUE NORTH, SUITE 204E
BILLINGS MT
59101
US

V. Phone/Fax

Practice location:
  • Phone: 406-237-5001
  • Fax: 406-237-5010
Mailing address:
  • Phone: 406-237-5001
  • Fax: 406-237-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMED-PAC-LIC-60481
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMED-PAC-LIC-6048
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: