Basic Information
| Provider Information | |||||||||
| NPI: | 1871094177 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | BRITTNEY | ||||||||
| MiddleName: | KIMIKO | ||||||||
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| Credential: | PA-C, MPAS, CST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6262 VETERANS PKWY | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319093540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7064943071 | ||||||||
| FaxNumber: | 7064943008 | ||||||||
| Practice Location | |||||||||
| Address1: | 5475 S 500 E | ||||||||
| Address2: | |||||||||
| City: | OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844056905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014792111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2018 | ||||||||
| LastUpdateDate: | 03/08/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | UT | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.