Individual
JESSICA ANN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6656 DOBBIN RD, COLUMBIA, MD 21045-5841
(410) 381-1330
Mailing address
6656 DOBBIN RD, COLUMBIA, MD 21045-5841
(410) 381-1330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110-006704
VA
363A00000X
Physician Assistant
9475
GA
363A00000X
Physician Assistant
Primary
C06942
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110-006704
VIRGINIA BOARD OF MEDICINE
VA
01
—
9475
GEORGIA COMPOSITE MEDICAL BOARD
GA
01
—
C06942
MARYLAND BOARD OF PHYSICIANS
MD
Enumeration date
09/13/2018
Last updated
10/23/2024
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