Individual
EBONY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 BERNARDINE DR, NEWPORT NEWS, VA 23602-4499
(578) 866-2717
Mailing address
2 BERNARDINE DR, NEWPORT NEWS, VA 23602-4499
(578) 866-2717
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110010211
VA
Other
Enumeration date
01/01/2024
Last updated
10/28/2024
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