Provider Demographics
NPI:1336937416
Name:MINCY, WESLEY TAYLOR (PA-S)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:TAYLOR
Last Name:MINCY
Suffix:
Gender:
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5958
Mailing Address - Country:US
Mailing Address - Phone:919-948-8401
Mailing Address - Fax:
Practice Address - Street 1:205 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5958
Practice Address - Country:US
Practice Address - Phone:919-948-8401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical