Provider Demographics
NPI:1093588097
Name:DUNKLEBERGER, BRYNN MARIE (MPAS, PA-C)
Entity Type:Individual
Prefix:MISS
First Name:BRYNN
Middle Name:MARIE
Last Name:DUNKLEBERGER
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:2057 REED ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3916
Mailing Address - Country:US
Mailing Address - Phone:570-220-6724
Mailing Address - Fax:
Practice Address - Street 1:1800 E PARK AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6701
Practice Address - Country:US
Practice Address - Phone:814-231-7000
Practice Address - Fax:814-231-7022
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA065190363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical