Provider Demographics
NPI:1063026805
Name:TAYLOR, ARLENE CAROL CHANDICK (PA-C)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:CAROL CHANDICK
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3349 ONSLOW DR
Mailing Address - Street 2:
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-1421
Mailing Address - Country:US
Mailing Address - Phone:216-903-0946
Mailing Address - Fax:
Practice Address - Street 1:51 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7327
Practice Address - Country:US
Practice Address - Phone:910-577-5199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant