Provider Demographics
NPI:1326371865
Name:FLUKE, MARIE JAMIE (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:JAMIE
Last Name:FLUKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:JAMIE
Other - Last Name:GEIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7096 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:NEW TRIPOLI
Mailing Address - State:PA
Mailing Address - Zip Code:18066
Mailing Address - Country:US
Mailing Address - Phone:610-298-8521
Mailing Address - Fax:610-298-3021
Practice Address - Street 1:7096 DECATUR ST
Practice Address - Street 2:
Practice Address - City:NEW TRIPOLI
Practice Address - State:PA
Practice Address - Zip Code:18066-3815
Practice Address - Country:US
Practice Address - Phone:610-298-8521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054093363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant