Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACKSON TARAVINE
Active Sole ProprietorJACKSON TARAVINE is a Medical Physician Assistant healthcare provider located in SURPRISE, Arizona. NPI 1811770910 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · SURPRISE, AZ
Registration Details
- NPI Number
- 1811770910
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 14, 2023 (3.0474474714222 yrs)
- Last Updated
- May 21, 2024
- Licenses
-
70349500001 (AZ)7047150001 (AZ)7209350001 (AZ)7939960001 (AZ)704516001 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
14239 W BELL RD STE 108SURPRISE, AZ, 853742470Browse AZ providers · Browse ZIP 85374
- Phone
- 6232484283
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Durable Medical Equipment & Medical Supplies
- Additional Specialty
- Durable Medical Equipment & Medical Supplies
- Additional Specialty
- Durable Medical Equipment & Medical Supplies
- Additional Specialty
- Durable Medical Equipment & Medical Supplies
Other Medical Physician Assistant Providers in SURPRISE, AZ
| Name | Credential | NPI |
|---|---|---|
| NANCY J COOPER | PA | 1346241940 |
| JOHANNA M BROOKS | PA-C | 1700835642 |
| MRS. APRIL S BASS | PA | 1164524211 |
| ZACHARY MICHAEL BARTLETT | PA-C | 1457435703 |
| MR. STEFAN IACOB | PA-C | 1851437503 |
| COURTNEY A. CAHILL | PA-C | 1346453487 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.