Most Relevant Information
Provider Data
| NPI Number: | 1003220062 |
| Provider Name: | TAYLOR NICOLE THOMPSON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | PAT0063 |
Most Important Dates
| Enumeration Date: | 06/18/2014 |
| Last Updated: | 07/02/2015 |
Provider Practice Location
5501 OLD YORK RD
KORMAN BUILDING SUITE 202
PHILADELPHIA
PA
191413018
Practice Location Phone/Fax
| Phone: | 2152542630 |
| Fax: |
Provider Mailing Location
5501 OLD YORK RD
PHILADELPHIA
PA
191413018
Provider Mailing Phone/Fax
| Phone: | 2152542630 |
| Fax: |