Individual
TAYTUM RAE VERMILYEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1050 GAIL GARDNER WAY STE 300, PRESCOTT, AZ 86305-1640
(928) 717-5232
(928) 717-5238
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10488
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187380
—
AZ
Enumeration date
07/19/2024
Last updated
04/08/2026
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