Weston, Taylor Davianna

Weston, Taylor Davianna is an sole proprietor health care provider with primary practice located at 2651 E Discovery Pkwy , Bloomington IN 47408-9059. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Weston, Taylor Davianna can be contacted via phone (812) 353-9515.

Contact Information

Primary practice address
2651 E Discovery Pkwy Bloomington IN 47408-9059
Fax:
Website:

Profile Details

NPI number 1407554249
LBN Legal business name Weston, Taylor Davianna
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2023
Last updated Jun 8th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407554249 NPPES
Indiana Other 090540851 MEDICARE PTAN
Indiana MEDICAID 300073584 MEDICARE PTAN

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