Provider Demographics
NPI:1366483901
Name:LASHER, BROOKE (MSPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:LASHER
Suffix:
Gender:F
Credentials:MSPAS, PA-C
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPAS,PA-C
Mailing Address - Street 1:116 S GEORGE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1474
Mailing Address - Country:US
Mailing Address - Phone:717-845-8617
Mailing Address - Fax:717-854-6645
Practice Address - Street 1:116 S GEORGE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-1474
Practice Address - Country:US
Practice Address - Phone:717-845-8617
Practice Address - Fax:717-854-6645
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
PAMA056886363A00000X
TXPA05181363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA373212EBXMedicare PIN
TXTXB135334Medicare PIN
TXTXB135332Medicare PIN
TX8L26090Medicare PIN
TX8L26088Medicare PIN
TXTXB135335Medicare PIN