Provider Demographics
NPI:1164015970
Name:WINSLOW, TAYLOR ALYSE (PA)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALYSE
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 W MCINTOSH RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-6136
Mailing Address - Country:US
Mailing Address - Phone:678-451-6348
Mailing Address - Fax:
Practice Address - Street 1:5530 W MCINTOSH RD
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-6136
Practice Address - Country:US
Practice Address - Phone:678-451-6348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical