Provider Demographics
NPI:1144598087
Name:BETSCHART, AMY ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:BETSCHART
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 1:11676 PERRY HIGHWAY
Mailing Address - Street 2:SUITE 2305
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7200
Mailing Address - Country:US
Mailing Address - Phone:724-935-9133
Mailing Address - Fax:724-935-8711
Practice Address - Street 1:11676 PERRY HIGHWAY
Practice Address - Street 2:SUITE 2305
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7200
Practice Address - Country:US
Practice Address - Phone:724-935-9133
Practice Address - Fax:724-935-8711
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055243363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant