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Individual
REGINA RAE TAYLOR
Active
Individual
REGINA RAE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01839
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-01839
KANSAS STATE LICENSE
KS
Enumeration date
09/24/2015
Last updated
11/05/2015
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