Provider Demographics
NPI:1275132656
Name:STECKLEIN, JESSICA HALEY (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:HALEY
Last Name:STECKLEIN
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 1:696 FIR AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-5450
Mailing Address - Country:US
Mailing Address - Phone:215-478-2145
Mailing Address - Fax:
Practice Address - Street 1:696 FIR AVE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-5450
Practice Address - Country:US
Practice Address - Phone:215-478-2145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-18
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061901363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical