Provider Demographics
NPI:1528409810
Name:MESSICK, ELIZABETH LAUREN (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LAUREN
Last Name:MESSICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LAUREN
Other - Last Name:VANSANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:16 MANOR AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17551-1132
Mailing Address - Country:US
Mailing Address - Phone:717-872-5444
Mailing Address - Fax:717-872-1537
Practice Address - Street 1:16 MANOR AVE STE A
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17551-1132
Practice Address - Country:US
Practice Address - Phone:717-872-5444
Practice Address - Fax:717-872-1537
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056197363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant