Individual
TAYLOR MICHELLE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
128 NEUROSCIENCE CT, GRAY, LA 70359-5209
(985) 917-3007
(985) 917-3010
Mailing address
128 NEUROSCIENCE CT, GRAY, LA 70359-5209
(985) 917-3007
(985) 917-3010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
324793
LA
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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