Provider Demographics
NPI:1447894639
Name:DONOHO, TAYLOR ABIGAIL (PA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ABIGAIL
Last Name:DONOHO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 E TIPTON ST
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-3533
Mailing Address - Country:US
Mailing Address - Phone:812-405-2039
Mailing Address - Fax:812-405-2059
Practice Address - Street 1:1414 E TIPTON ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-3533
Practice Address - Country:US
Practice Address - Phone:812-405-2039
Practice Address - Fax:812-405-2059
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
IN10002866A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01051996AOtherSTATE LICENSE