Provider Demographics
NPI:1174490114
Name:MAYER, JAMIE NOEL (PA-C)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:NOEL
Last Name:MAYER
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 1:235 BYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4011
Mailing Address - Country:US
Mailing Address - Phone:215-514-8581
Mailing Address - Fax:
Practice Address - Street 1:915 OLD FERN HILL RD STE 300
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-3431
Practice Address - Country:US
Practice Address - Phone:610-431-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066693363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant