Provider Demographics
NPI:1255844668
Name:POHLE, TAYLOR (PA-C)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:POHLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TAYLOR POHLE, PA-C, ST. VINCENT HEART INSTITUTE-CARDIOL
Mailing Address - Street 2:2900 12TH AVENUE NORTH, SUITE 204E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101
Mailing Address - Country:US
Mailing Address - Phone:406-237-5001
Mailing Address - Fax:406-237-5010
Practice Address - Street 1:SAINT VINCENT HEART INSTITUTE-CARDIOLOGY, YELLOWSTONE
Practice Address - Street 2:2900 12TH AVENUE NORTH, SUITE 204E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101
Practice Address - Country:US
Practice Address - Phone:406-237-5001
Practice Address - Fax:406-237-5010
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-60481363A00000X
MTMED-PAC-LIC-6048363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant