Individual
TAMARA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2706
(812) 238-7000
(812) 238-7444
Mailing address
135 ARCH AVE APT 2, GREENSBURG, PA 15601-2518
(317) 508-3408
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA16004
TX
363AM0700X
Medical Physician Assistant
Primary
PA2014-0063
NM
363L00000X
Nurse Practitioner
10000435A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000528327
ANTHEM
IN
Enumeration date
10/04/2006
Last updated
09/25/2024
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