Individual
TAYLOR MORGAN CHRISTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RDN, IFMCP
Contact information
Practice address
114 SE H ST APT 203, BENTONVILLE, AR 72712-2717
(918) 521-4140
Mailing address
114 SE H ST APT 203, BENTONVILLE, AR 72712-2717
(918) 521-4140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-917
AR
363A00000X
Physician Assistant
PA14367
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
474071019
TAILORED PERSONALIZED NUTRITION LLC
OK
Enumeration date
01/06/2015
Last updated
10/04/2023
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