Provider Demographics
NPI:1245929777
Name:LAHL, TAYLER (PA-C)
Entity type:Individual
Prefix:
First Name:TAYLER
Middle Name:
Last Name:LAHL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TAYLER
Other - Middle Name:
Other - Last Name:PAULSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7300 FRANCE AVE S STE 420
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4504
Mailing Address - Country:US
Mailing Address - Phone:952-832-5252
Mailing Address - Fax:
Practice Address - Street 1:7300 FRANCE AVE S STE 420
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4504
Practice Address - Country:US
Practice Address - Phone:952-832-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15089363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant