Provider Demographics
NPI:1932994795
Name:TAYLOR, JAYLA LAVELLE (PA)
Entity type:Individual
Prefix:MISS
First Name:JAYLA
Middle Name:LAVELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1012 WESTYN TERRACE LOOP APT 202
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-5059
Mailing Address - Country:US
Mailing Address - Phone:843-338-3408
Mailing Address - Fax:
Practice Address - Street 1:1901 TATE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1109
Practice Address - Country:US
Practice Address - Phone:434-200-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty