Provider Demographics
NPI:1346471414
Name:INMAN, ANESSA C (PA-C)
Entity Type:Individual
Prefix:
First Name:ANESSA
Middle Name:C
Last Name:INMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANESSA
Other - Middle Name:C
Other - Last Name:GOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:205 SAINT CHARLES WAY
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4659
Mailing Address - Country:US
Mailing Address - Phone:717-741-4666
Mailing Address - Fax:717-741-9649
Practice Address - Street 1:205 SAINT CHARLES WAY
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4659
Practice Address - Country:US
Practice Address - Phone:717-741-4666
Practice Address - Fax:717-741-9649
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053925363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA404162FLTMedicare PIN