Provider Demographics
NPI:1518521871
Name:WEINTRAUB, TAYLOR NICOLE
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:NICOLE
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 HOWELL MILL RD NW STE 101
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4107
Mailing Address - Country:US
Mailing Address - Phone:404-351-7546
Mailing Address - Fax:404-351-2993
Practice Address - Street 1:3280 HOWELL MILL RD NW STE 101
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4107
Practice Address - Country:US
Practice Address - Phone:404-351-7546
Practice Address - Fax:404-351-2993
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13217363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical