Provider Demographics
NPI:1235471293
Name:SCHELLHASE, MEREDITH JEAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:JEAN
Last Name:SCHELLHASE
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 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-749-3181
Mailing Address - Fax:717-349-3191
Practice Address - Street 1:8131 SPYGLASS HILL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-5500
Practice Address - Country:US
Practice Address - Phone:717-749-3181
Practice Address - Fax:717-349-3191
Is Sole Proprietor?:No
Enumeration Date:2013-03-17
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055942363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103149291Medicaid
PA1007307260057OtherMEDICAID GROUP #
PA867633OtherMEDICARE GROUP #
PA103149291Medicaid