Provider Demographics
NPI:1194219717
Name:KESSLER, REGAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:REGAN
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:REGAN
Other - Middle Name:
Other - Last Name:KAESTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:CA410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:30 HOPE DR STE 2400
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2036
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:717-531-0983
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA004480363A00000X
PAMA059806363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103526459Medicaid