Taylor Kane Rickenbaker, PA-C
Physician Assistant, Surgical in Virginia Beach, VA. Individual provider (NPI-1).
NPI number1033450010
StatusActive
Last updated in NPPESJan 19, 2022
Details
- NPI
- 1033450010
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Taylor Kane Rickenbaker
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 15, 2013
- Certification date
- Jan 19, 2022
- Last updated
- Jan 19, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 0110007929 | VA | Yes |
| 363AS0400X | Physician Assistant, Surgical | – | – | |
| 246ZS0410X | Specialist/Technologist, Other, Surgical Technologist | – | – | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Other names
- Taylor Kane Jacobson (Former Name)
Practice location
144 S Gum AveVirginia Beach, VA 23452-1221
Phone 229-291-1727
Mailing address
144 S Gum AveVirginia Beach, VA 23452-1221
Phone 229-291-1727
Other practice locations
397 Little Neck Rd Ste 120
Virginia Beach, VA 23452-5774
Virginia Beach, VA 23452-5774
Phone 757-395-1600 · Fax 757-961-9359
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