Individual provider · Type 1 NPI

Taylor Erin D'etcheverry, PA-C

Physician Assistant · Charleston, WV

NPI number 1669943890 Active

Practice location

3100 Maccorkle Ave SE Ste 101
Charleston, WV 25304-1215

Call (304) 388-5395 Map

Other practice locations

  • 20560 Southport Landing Pl, Smithfield, VA 23430-8116 · (757) 870-1865
  • 1200 J D Anderson Dr, Morgantown, WV 26505-3494 · (304) 598-1996
  • 600 Gresham Dr Ste 8630B, Norfolk, VA 23507-1904 · (757) 388-6115

Specialties and licenses

TaxonomyCodeLicense
Surgical Critical Care Physician 2086S0102X2268 (WV)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Physician Assistant Primary 363A00000X0110009282 (VA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1669943890

Taylor Erin D'etcheverry, PA-C's National Provider Identifier is 1669943890, issued on Dec 16, 2018. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Charleston, WV. The record was last updated on Aug 8, 2025.