Provider Demographics
NPI:1194421248
Name:MESSINGER, TAYLOR MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELLE
Last Name:MESSINGER
Suffix:
Gender:
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 1:2221 PARSON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-1953
Mailing Address - Country:US
Mailing Address - Phone:419-708-6850
Mailing Address - Fax:
Practice Address - Street 1:270 COPPERFIELD BLVD NE STE 102
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2443
Practice Address - Country:US
Practice Address - Phone:704-786-6521
Practice Address - Fax:704-782-9703
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-12857363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant