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NPI Code Detail

MEDICARE: NICOLE E TAYLOR PA-C

MEDICARE:   NICOLE E TAYLOR  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
1363AM0700XMedical Physician Assistant6827AZ

General Provider Information

NPI Number : 1467978320
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE E TAYLOR PA-C
Provider Business Mailing Address
First Line : 2525 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4948
Country : US
Telephone Number : 602-344-5608
Fax Number : 602-655-9184
Provider Business Practice Location Address
First Line : 2525 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4948
Country : US
Telephone Number : 602-344-5608
Fax Number : 602-655-9184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 12/01/2025

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Directions to “ NICOLE E TAYLOR PA-C” Practice Location

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