Basic Information
| Provider Information | |||||||||
| NPI: | 1811516784 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BITTER | ||||||||
| FirstName: | TAYLER | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7060 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852467060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804442017 | ||||||||
| FaxNumber: | 4807181301 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 S PHELPS DR | ||||||||
| Address2: | |||||||||
| City: | APACHE JUNCTION | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851206700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805366850 | ||||||||
| FaxNumber: | 4807181301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2020 | ||||||||
| LastUpdateDate: | 02/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 8177 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.