Provider Demographics
NPI:1407558802
Name:WESTROM, TAYLOR ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:WESTROM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12500 W 164TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-8404
Mailing Address - Country:US
Mailing Address - Phone:913-488-0924
Mailing Address - Fax:
Practice Address - Street 1:100 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-1126
Practice Address - Country:US
Practice Address - Phone:913-755-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-02720207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine