Provider Demographics
NPI:1437524287
Name:HOENICH, PAMELA SUZANNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:SUZANNE
Last Name:HOENICH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:SUZANNE
Other - Last Name:MOULSDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2200 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1002
Mailing Address - Country:US
Mailing Address - Phone:717-695-0007
Mailing Address - Fax:717-889-0205
Practice Address - Street 1:2200 DOVER RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1002
Practice Address - Country:US
Practice Address - Phone:410-458-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA006799363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant