Andrea Leigh Wickus in Leesport - Physician Assistant
Andrea Leigh Wickus - NPI 1104881879
Andrea Leigh Wickus is a Physician Assistant in Leesport, Pennsylvania. Andrea Leigh Wickus practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Andrea Leigh Wickus is 1104881879. The last update date is 2023-01-20.
Andrea Leigh Wickus's current location address is 5 S Centre Ave, Leesport, Pennsylvania. You can contact this provider via phone number 6109265707 and fax number 6109268352. The mailing address for Andrea Leigh Wickus is 5 S Centre Ave, Leesport, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
Provider Name | Andrea Leigh Wickus |
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Address | 5 S Centre Ave, Leesport, Pennsylvania |
Phone Number | 6109265707 |
Fax Number | 6109268352 |
Sole Proprietor | Y |
Credentials | PAC |
NPI Number Detail
NPI Number | 1104881879 |
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Provider Enumeration Date | 2006-04-18 |
Last Updated Date | 2023-01-20 |
Provider Mailing Address Detail
Address | 5 S Centre Ave |
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City | Leesport |
State | Pennsylvania (PA) |
Post Code | 195338653 |
Phone Number | 6109265707 |
Fax Number | 6109268352 |
Provider's Primary Taxonomy Detail
Speciality | Physician Assistant |
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Taxonomy | 363A00000X |
Licence No | OA005642 |
Definition: 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 perfor |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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50053971 | PA | CAPITAL BLUE CROSS |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Andrea Leigh Wickus by the Centers for Medicare & Medicaid Services?
The Andrea Leigh Wickus has been assigned the NPI (National Provider Identifier) 1104881879 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of Andrea Leigh Wickus?
The Andrea Leigh Wickus is situated at 5 S Centre Ave, in the city of Leesport, state of PA, with the zip code 195338653.
What is Andrea Leigh Wickus's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Andrea Leigh Wickus's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
When was the Andrea Leigh Wickus's 1104881879 issued?
The Andrea Leigh Wickus's 1104881879 was issued on 2006-04-18.
When was the Andrea Leigh Wickus's information last updated?
The Andrea Leigh Wickus's information was last updated on 2023-01-20.