Individual
MRS. AMANDA NICOLE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5751 EDWARDS RANCH RD STE 200, FORT WORTH, TX 76109-4120
(817) 332-8848
(817) 335-2670
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8450
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12858
TX
Other
Enumeration date
06/24/2019
Last updated
03/03/2020
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