Provider Demographics
NPI:1447983424
Name:EVANS, TAYLOR (PA-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MARY HIGGINSON LN
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2657
Mailing Address - Country:US
Mailing Address - Phone:724-438-8300
Mailing Address - Fax:724-438-8340
Practice Address - Street 1:204 MARY HIGGINSON LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2657
Practice Address - Country:US
Practice Address - Phone:724-438-8300
Practice Address - Fax:724-438-8340
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA065138363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant