Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 14659 | NV |
Y | 207VG0400X | Gynecologist | 41803 | AZ |
N | 207VG0400X | Gynecologist | A83243 | CA |
NPI | 1073753570 |
---|---|
Provider Name | Deshawn Taylor |
First Address | Waddell, AZ 85355 |
Second Address | Phoenix, AZ 85021-8576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2009 |
Last Update Date | 08/07/2013 |