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
Phone: (812) 353-9515
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 10003957A | Indiana |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407554249 | NPPES |
Indiana | Other | 090540851 | MEDICARE PTAN |
Indiana | MEDICAID | 300073584 | MEDICARE PTAN |
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