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Individual
JARED ROSS TAYLOR
Active
Individual
JARED ROSS TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
FNP-363LF0000X
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
414670
—
AZ
01
—
4378
ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS
AZ
01
—
CS22548
NEVADA STATE BOARD OF PHARMACY
NV
01
—
PA1142
NEVADA BOARD OF MEDICAL EXAMINERS
NV
Enumeration date
02/26/2009
Last updated
06/20/2018
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