NPI 1881385656 · live from the CMS NPI Registry
Taelor Baetz, PA
Physician Assistant in Ponca City, OK. National Provider Identifier 1881385656, active.
NPI record
| NPI | 1881385656 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 415 Fairview Ave Ste 201, Ponca City, OK 74601 |
| Practice phone | 580-762-9355 |
| Mailing address | 3001 Quail Springs Pkwy Fl 5, Oklahoma City, OK 73134 |
| Enumerated | May 15, 2023 |
| Last updated | July 10, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 5266 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.