Taylor, Raven Nicole

Taylor, Raven Nicole is an individual health care provider with primary practice located at 21321 E Ocotillo Rd Ste 133 , Queen Creek AZ 85142-5995. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Taylor, Raven Nicole can be contacted via phone (480) 987-5525.

Contact Information

Primary practice address
21321 E Ocotillo Rd Ste 133 Queen Creek AZ 85142-5995
Phone: (480) 987-5525
Fax: (480) 987-5115
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 7335 Arizona

Profile Details

NPI number 1841772282
LBN Legal business name Taylor, Raven Nicole
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2018
Last updated Jan 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1841772282 NPPES
Arizona MEDICAID 008331

Popular Providers