Provider Demographics
NPI:1033145057
Name:DEMPSEY, AYNN JUDE (PA-C)
Entity Type:Individual
Prefix:
First Name:AYNN
Middle Name:JUDE
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 WESTMARCH CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9420
Mailing Address - Country:US
Mailing Address - Phone:301-662-3216
Mailing Address - Fax:301-947-9513
Practice Address - Street 1:803 RUSSELL AVE
Practice Address - Street 2:SUITE #1, SMC
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3584
Practice Address - Country:US
Practice Address - Phone:301-869-0700
Practice Address - Fax:301-947-9513
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002843363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC0002843OtherMARYLAND CERT #