Provider Demographics
NPI:1336659457
Name:DUBBS, NOELLE LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:LOUISE
Last Name:DUBBS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:LOUISE
Other - Last Name:BRICKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1861 POWDER MILL RD
Mailing Address - Street 2:ATTN: MEDICAL STAFF OFFICE
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4723
Mailing Address - Country:US
Mailing Address - Phone:717-718-2041
Mailing Address - Fax:717-718-3470
Practice Address - Street 1:1855 POWDER MILL RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-848-4800
Practice Address - Fax:717-741-9867
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059352363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant