Individual
TAYLOR VANSANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1825 HWY 34 E STE 1200, NEWNAN, GA 30265-3892
(770) 502-2121
Mailing address
165 WENDELL COURT, FAYETTEVILLE, GA 30215
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11539
GA STATE LICENSE
GA
Enumeration date
01/18/2022
Last updated
05/08/2023
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