Provider Demographics
NPI:1730651639
Name:HERKERT, TAYLOR LEE (PA)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LEE
Last Name:HERKERT
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 1:7400 FRANCE AVE.
Mailing Address - Street 2:SUITE #100
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435
Mailing Address - Country:US
Mailing Address - Phone:763-537-6000
Mailing Address - Fax:763-767-7158
Practice Address - Street 1:7400 FRANCE AVE.
Practice Address - Street 2:SUITE #100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:763-537-6000
Practice Address - Fax:763-767-7158
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant