Individual
TAYLOR BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
238 BROOKLEY AVE SW BLDG 1300, BOLLING AFB, DC 20032-7704
(202) 404-2544
(202) 404-3197
Mailing address
238 BROOKLEY AVE SW BLDG 1300, BOLLING AFB, DC 20032-7704
(202) 404-2544
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
03/20/2015
Last updated
10/15/2024
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