Provider Demographics
NPI:1184686701
Name:PHEBUS, AMY TERESA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:TERESA
Last Name:PHEBUS
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 1:370 HARMONY SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:WV
Mailing Address - Zip Code:26801-8163
Mailing Address - Country:US
Mailing Address - Phone:304-897-5301
Mailing Address - Fax:
Practice Address - Street 1:370 HARMONY SPRINGS LN
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:WV
Practice Address - Zip Code:26801-8163
Practice Address - Country:US
Practice Address - Phone:304-897-5301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant