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Individual

MRS. TAYLOR BOONE CONLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
15 MEDICAL DR NE STE 101, CARTERSVILLE, GA 30121-8005
(770) 386-5221
(770) 386-1128
Mailing address
15 MEDICAL DR NE STE 101, CARTERSVILLE, GA 30121-8005
(770) 386-5221
(770) 386-1128

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14133920
CAQH
Enumeration date
08/29/2017
Last updated
10/24/2022
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