Provider Demographics
NPI:1619607710
Name:TAYLOR, SAVANNAH RAE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SAVANNAH RAE
Middle Name:
Last Name:TAYLOR
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 1:512 N COLLEGE ST # T2403
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3479
Mailing Address - Country:US
Mailing Address - Phone:973-668-6293
Mailing Address - Fax:
Practice Address - Street 1:136 E 36TH ST STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2018
Practice Address - Country:US
Practice Address - Phone:704-801-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant