Individual
AMANDA NICOLE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3011 E BARNETT RD, MEDFORD, OR 97504
(541) 789-4673
(541) 789-2121
Mailing address
PO BOX 4749, MEDFORD, OR 97501-0227
(541) 789-4111
(541) 789-5518
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA201837
OR
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
05/01/2019
Last updated
01/17/2022
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