Provider Demographics
NPI:1437839941
Name:NALDER, TAYLA (PA-C)
Entity Type:Individual
Prefix:
First Name:TAYLA
Middle Name:
Last Name:NALDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TAYLA
Other - Middle Name:
Other - Last Name:KNOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:672 S RED MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:IVINS
Mailing Address - State:UT
Mailing Address - Zip Code:84738-1224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:295 S 1470 E STE 102
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1961
Practice Address - Country:US
Practice Address - Phone:435-222-5527
Practice Address - Fax:435-216-0560
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant