MEDICARE: TAYLOR NESBIT PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA0009119	CO
2	363A00000X	Physician Assistant	PA9113295	FL
3	363AM0700X	Medical Physician Assistant	PA9113295	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457969867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR NESBIT PA-C

Provider Business Mailing Address
First Line	:	1560 BROADWAY STE 1600
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-5160
Country	:	US
Telephone Number	:	727-617-0070
Fax Number	:	813-212-0479

Provider Business Practice Location Address
First Line	:	1560 BROADWAY STE 1600
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-5160
Country	:	US
Telephone Number	:	727-617-0070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2020
Last Update Date	:	09/08/2025

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Directions to “ TAYLOR NESBIT PA-C” Practice Location

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