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General NPI Number Information
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NPI Number | 1376053660
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Entity Type | Individual
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Provider Name | TAYLOR COVINGTON LAVERY PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 1901 TATE SPRINGS RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1109
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Country | US
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Telephone | 434-200-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 503 CHURCH ST APT 3
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City | LYNCHBURG
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State | VA
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Zip | 24504-1339
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Country | US
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Telephone | 804-627-2851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110-005941
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License Number State | VA
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