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Individual
TARA LEIGH TAYLOR
Active
Individual
TARA LEIGH TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004211
MI
363AM0700X
Medical Physician Assistant
TT004211
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TT004211
STATE LICENSE
MI
Enumeration date
08/05/2007
Last updated
03/06/2023
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